AC 4369 Library Plon 69 117 PORT HEALTH AUTHORITY OF THE PORT OF LONDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH To 31st DECEMBER, 1961. 117 PORT HEALTH AUTHORITY OF THE PORT OF LONDON ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH JOHN GREENWOOD WILSON, M.D F R.C.P., D P.H., F.A.P.H.A. (Hon). Fellow of King's College, London. To 31st DECEMBER, 1961. Telegraphic Address: "PORTELTH LONDON" Telephone Number: MONarch 3030. CONSTITUTION AND JURISDICTION The governing body of the City of London, the Corporation of London, was originally constituted the Sanitary Authority of the Port of London by Section 20 of the Public Health Act, 1872. The cost of administration was met from the Corporation's private funds for close on fifty years, when it became rate (and grant) aided. By the Public Health (London) Act, 1936, the term "Port Sanitary" was changed to "Port health", and the Port Health district is further defined by that Act as the "Port of London as established for the purposes of the law relating to the Customs of the United Kingdom" and by the Public Health Act, 1936 as "the Port as established for the purposes of the enactments relating to the Customs". The limits of the Port Health District of the Port of London are still as originally defined by a Treasury Minute dated 1st August, 1883. They commence at high water mark in the River Thames at Teddington Lock, in the County of Surrey, and extend down both sides of the said River Thames to an imaginary straight line drawn from the Pilot mark at the entrance of Havengore Creek in the County of Essex, to the Land's End at Warden Point, in the Isle of Sheppey, in the County of Kent, such point being the north-western limit of the Port of Faversham, and extend up and include both sides of the River Medway to an imaginary straight line drawn from the south-east point of land westward of Coalmouth Creek, thence across the said River Medway to the western-most point of the piece of land which forms the eastern side of Stangate Creek, or, in other words, the north-west point of Fleet Marsh and thence in a southerly direction to Iwade Church in the said County of Kent, and thence in a north-easterly direction to Elmley Chapel in the said Isle of Sheppey, a supposed direct line from Elmley Chapel to Iwade Church, being the western limit of the Port of Faversham, and the said Port of London includes the Islands of Havengore Creek aforesaid, called Potton and Rushley Islands, and so much of the said Creek and Watercourses as extends from it to the town of Rochford, and also includes all other Islands, Rivers, Streams, Creeks, Waters, Watercourses, Channels, Harbours, Docks and places within the before-mentioned limits contained. The Port of London Authority with which the Port Health Authority works in close cooperation, was established as the administrative body of the Port of London including the docks and tideway of the River Thames, by Act of Parliament in 1909. The limits of its jurisdiction are about the same as, but not quite so extensive as those of the Port Health Authority. 2 January, 1962. To THE RIGHT HONOURABLE THE LORD MAYOR, ALDERMEN AND COMMONERS OF THE CORPORATION OF LONDON My Lord Mayor and Gentlemen, I have the honour to submit as Medical Officer of Health for the Port of .London my Annual Report for the year ending 31st December, 1961. A letter from the Secretary, Ministry of Health, dated 28th December, 1961, contained a reminder that the Medical Officer of Health should prepare his Annual Report on the lines indicated in Form 20 enclosed with Circular 33/52 of the 6th November, 1952, adapted as may be necessary to the special needs of the administration of the London Port Health District. Paragraph 5 of Form Port 20 reads as follows: "The information required by Sections I, V, VI, VIII, XIV and XVI, which has been given in an earlier report and has not since changed, need not be repeated each year. A recapitulation of all information should be made in the Report for the years 1952 and 1955 and thereafter quinquennially. For the intermediate years, only the changes which have occurred during the year covered by the Report need be mentioned in those Sections; if there is no change, "No Change" should be entered. This Report has been prepared in accordance with the above directive. The following is a summary of the principal items mentioned in this Report:— Shipping The number of vessels arriving in the Port of London during 1961 was 27,363, 16,498 from foreign ports and 10,865 coastwise. The total tonnage of these arrivals was 44,370,892 net tons as compared with 44,187,470 tons in 1960. The Boarding Medical Officers visited 1,739 vessels from foreign ports and eight coastwise ships. The Port Health Inspectors made 14,042 inspections of vessels, 11,969 of which were foreign-going, 1,376 coastwise and 697 inland navigation. Communicable Diseases 381 cases of notifiable and other infectious diseases were reported as having occurred on 165 vessels, 150 of these cases were dealt with in the Port. 80 cases were admitted to various hospitals, including 54 to the Port Isolation Hospital at Denton, nr. Gravesend. No case of smallpox reached the Port but full precautionary measures were taken on two vessels following information of suspected cases of smallpox having been landed abroad. The Port Health Authority continues to act as a general health service for the River, particularly at Gravesend, and undertakes duties not strictly limited to quarantine but which the Service with its own medical staff, ambulance launches and port health inspectors, is under a moral obligation to fulfil. Prompt assistance to medical emergencies has been greatly facilitated by the use of radio-telephony on the Port Health Authority craft and by the most excellent cooperation of the P.L.A. Thames Navigation Service. Rodent Control During the year 4,736 rats, 2,811 in ships and 1,925 in shore premises, were destroyed in the Port of London. In addition, 3,404 mice were destroyed, 675 in ships and 2,729 in shore premises. 121 rats were examined for plague with negative results. 6,366 inspections of lighters were made for evidence of rodents. International Deratting and Deratting Exemption Certificates The number of Deratting Certificates issued was 104, the method of deratting in 91 instances being '1080'. 964 Deratting Exemption Certificates were granted. Shellfish No cases were reported of food poisoning or other illness resulting from the consumption of shellfish taken from layings within the district of the Port Health Authority. Medical Inspection of Aliens 15,356 aliens arriving by ship were medically inspected by the Port Health Authority's Medical Officers on behalf of the Immigration Department of the Home Office. Imported Food The total amount of foodstuffs seized and condemned as unfit for human consumption was 3,329 tons as compared with 3,511 tons in 1960. The work of inspection has progressed smoothly throughout the year, the Inspectors having received full co-operation from the Riparian Authorities, Shipping Companies, Importers and the Port of London Authority. In addition to routine work, special attention was necessary in connection with Nigerian and West African foods, Egyptian onions, cheese infected with staphyloccus aureos, desiccated coconut, frozen prawns, Bechuanaland boneless beef, Argentine horsemeat and the Dock Strike. 3 Clean Air Act Ship owners, masters of vessels and engineroom personnel, owners of tugs and the Port of London Authority have continued appreciably to assist in further reducing smoke from vessels. Only nineteen infringements by ships were observed. Legal proceedings were instituted in respect of three of these infringements and convictions obtained in each case. Transport of Refuse by Lighters Regular observation of refuse lighters has been maintained but no serious infringement of the Refuse Byelaws was noted. No legal proceedings were instituted. Houseboats Twenty-two houseboats were licenced to be moored at Benfleet in accordance with the provisions of the Essex County Council Act, 1952. Canal Boats 160 inspections of canal boats were made during the year. Fifty-four defects were found on thirty-three boats. Fertilisers and Feeding Stuffs Act 1936 Fourteen samples of feeding stuffs were submitted to the Agricultural Analyst. Oil Tankers 1057 ocean going tankers and 2,378 coasters berthed at the oil installations in the Thames Haven area during the year. Visitors and Students Qualified medical men and Public Health Inspectors from abroad and from local authorities and technical colleges in this country continue to visit the Port to obtain thoeretical and practical instruction in Port Health work. Launches The four launches continue to give regular and efficient service and credit for this must be given to the crews employed who are tireless in their efforts to maintain the condition and appearance of the vessels at a high level. The "Howard Deighton" is, however, now nearing the end of her career with the Authority and a new boarding cutter, the "Humphrey Morris" has been designed and launched and will shortly be in service. Lectures, Papers and Articles The paper by Dr. Greenwood Wilson and an article by Dr. Amphlett Williams are reproduced in Appendices (VI & VII) of this Report. Obituary and Retirements The death of Mr. W.L. McLorg and the retirement of Mr. P.W. Coombe occurred during the year. Finally, I wish to record my appreciation of the collaboration and assistance rendered by Her Majesty's Customs, the Pilots, the Immigration Officers, the Port of London Authority, the Shipping Federation, the staffs of Shipping Companies and Merchants, the staffs of the Central Public Health Laboratory and the "Dreadnought" Seamen's Hospital, the Public Analyst, the Emergency Bed Service, the South-East Metropolitan Regional Hospital Board, the Dartford Hospital Management Committee, and all those who have so generously and willingly helped me in every aspect of port health work throughout the year, particularly the Chairman and members of the Port and City of London Health Committee. I have the honour to be, Gentlemen, Your obedient Servant, J. GREENWOOD WILSON. APPENDICES (I) Medical Inspections (II) Infectious Diseases (III) Rodents (IV) Sanitary Inspections (V) Docks, Powers and Publications (VI) Paper on Imported Foods (VII) Article on Lead in tea 4 SECTION I - STAFF (As at 31st December 1961) TABLE A Name of Officer Nature of Appointment Date of Appointment Any other Appointment held J. Greenwood Wilson, M.D., F.R.C.P., D.P.H., F.A.P.H.A.(Hon.) Fellow of King's College, London Medical Officer of Health July, 1954 Medical Officer of Health, City of London. Medical Inspector of Aliens. H.M. Willoughby, V.R.D. & Bar, M.R.C.S., L.R.C.P., D.P.H., D.T.M. & H., Surgeon Capt. R.N.R. (Retd.), Late Q.H.P. Deputy Port Medical Officer of Health and Medical Officer in charge at Denton Hospital May, 1929 Medical Inspector of Aliens. J.A. Jones, M.B., Ch.B., D.P.H., Late Lieut.Col. R.A.M.C. First Assistant Port Medical Officer April, 1935 ditto P.J. Roden, L.M.S.S.A., Capt. R.A.M.C. (Retd.) Assistant Port Medical Officer (part-time) February, 1958 ditto D.T. Jones, B.Sc., M.B., B.Ch., Major R.A.M.C. (T.A. ditto March, 1958 ditto Marion Ravell, M.D., V M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Late Surgeon, M.N. Assistant Port Medical Officers (Locum Tenentes) March, 1956 - C.D. MacCarthy, M.B., B.Sc., B.A.O. Major R.A.M.C.(T.A.) A.W. Hagger, M.B., B.S., L V.R.D. Surg.Cdr. R.N.R. f R.G. Dewhurst, M.R.C.S. L.R.C.P., D.R.C.O.G. Late Fl. Lieut. R.A.F. (M.S.) R.G.W. Moore, M.B., B.S., Late Surg.Lieut.R.N.V.R. J.B. Evans, M.A., B.M., B.Ch. S P.S. Greaves, M.A., M.B., B. Chir., M.R.C.S., L.R.C.P. Assistant Port Medical Officer (part-time) October, 1960 J.O. Murray. M.D., M.B., Ch.B., D.P.H. ditto July, 1959 Medical Inspector of Aliens J- Fairrie, V.R.D., M.R.C.S., L.R.C.P. Part-time Assistant Medical Officer, Thameshaven and Shellhaven Area July, 1960 W.T.G. Boul, M.B.E.,M.D„ M.B., Ch.B., D.P.H. Infectious Disease Consultant March, 1957 — J.B. Maguire, B.A., M.B., C.Ch., B.D.O., L.M., (Rotunda) Part-time Medical Inspector of Aliens December, 1958 — D.J. Avery, M.R.C.S., L.R.C.P. ditto December, 1958 — W.T. Rougier Chapman, V.R.D.,M.R.C.S.,L.R.C.P. Temporary Assistant Port Medical Officer October, 1961 — ADMINISTRATIVE STAFF (Port and City of London) H.F. Blunt R.C. Ratliff Chief Clerk Deputy Chief Clerk May, 1924 March 1930 — J.E. Stout First Assistant Clerk August, 1930 — C.W.'R. Betts Senior Assistant April, 1926 — E.V. Smith ditto October, 1938 _ R.H. Lott First Class Assistant May, 1947 F.B. Osborn ditto May, 1952 — Miss M.L. Gurney General Grade Clerk May, 1939 _ Miss I.H. Hamblin ditto October, 1957 — Miss S. Campbell ditto January, 1960 _ G.J. Worwood Temporary General Grade Clerk October, 1961 — A.W. Bourne Messenger March, 1956 — T.A. Woods ditto November, 1955 — PORT HEALTH INSPECTORS T.L. Mackie, M.B.E., F.R.S.H., M.I.N.A. Chief Port Health Inspector and Supervisory Engineer of Launch Service November, 1934 — T.G. Edwards Senior Port Health Inspector June, 1929 — D.E. Madeley ditto September, 1932 — G. Dring ditto May, 1936 — A.H. Marshall ditto March, 1953 — A. Good ditto September, 1951 – 5 Name of Officer Nature of Appointment Date of Appointment Any other Appointment held PORT HEALTH INSPECTORS E.H. Johnson Port Health Inspector August, 1929 C.E. Wright ditto July, 1931 _ L.N. Tope ditto August, 1946 _ P.A. Traynier ditto October, 1950 T.C.H. Rogerson ditto October, 1951 W.M. Walker ditto October, 1954 A.W. Buchan ditto July, 1955 — F. Spencer ditto March, 1957 — W.C.B. Gilhespy ditto January, 1960 — W.R. Gwyer ditto March, 1960 — J.T. Healy ditto October, 1960 — A. Game ditto August, 1961 — STUDENT HEALTH INSPECTORS J.H. Rendell Student Health Inspector September, 1961 — D.M.A. Looker ditto ditto — P.G. Pritchard ditto ditto – MEAT SORTERS J.W. Goods Meat Sorter October, 1957 A.E. Deacon ditto August, I960 — RODENT INSPECTORS W.G. Stimson Senior Rodent Inspector February, 1946 C.W. Moody ditto February, 1929 - E.C. Watkins ditto June, 1929 — C. Stockton ditto June, 1940 — S.A. Croft Rodent Inspector June 1929 — D.J. Davis ditto August, 1941 — F.D. Cartman ditto September, 1943 — G. Lamont ditto March, 1945 — J.J. Harvey Rodent Operative November, 1959 RODENT CONTROL SCHEME H.A. Baxter Rodent Inspector June, 1945 – G. Clark ditto January, 1949 _ A.L. Southwood ditto January, 1949 — A.T. Evans ditto January, 1953 — C.E.W. Eastman ditto April, 1954 — J. Cook ditto July, 1956 — H.R.S. Tilley Rodent Operative March 1961 LAUNCHES AND HULKS J.R. Steen Navigator (Senior) March, 1926 _ W.S. Stimson Navigator (i/c Woolwich Station) March, 1944 — C.R. Simons Navigator (Deputy Senior) August, 1938 — W.G.A. King Navigator September, 1939 — H.J. Mason ditto August, 1946 _ M.J. East ditto September, 1924 S.J. Crutchley, D.S.M. Engineer (Senior) June, 1939 K. Gittens Engineer (Deputy Senior) January, 1955 _ E. Alewood Engineer January, 1947 W. Simmons ditto May, 1955 — A.R.L. Potter Deckhand July, 1945 — G. Cunningham ditto September, 1957 — B. Jacobs Vacancies (2) ditto April, 1956 – F. Sandys Deckboy May, 1959 J.L. Pay ditto September, 1959 — P. Rayner ditto November, 1960 J. Ballard ditto December, 1960 — K.W. Brooker ditto January, 1961 B.A. Wood ditto January, 1961 — S.K. Hogwood ditto July, 1961 — A. Russell ditto August, 1961 F.B. Morris Steward (part time) October, 1957 A.R. Burge Shipkeeper August, 1945 — L.C. Parish ditto May, 1958 R.H. Simmons Skipkeeper/Deckhand November, 1960 Launches— Date acquired "Howard Deighton" 1931 "Frederick Whittingham" 1934 "Alfred Robertson" 1938 "Alfred Roach" 194S Hulk — "Hygeia" 1935 6 SECTION II-AMOUNT OF SHIPPING ENTERING THE DISTRICT DURING THE YEAR TABLE B Ships from Number Net Tonnage Number Inspected Number of ships reported as having, or having had during the voyage infectious disease on board. By the Port Medical Officer By the Port Health Inspector Foreign Ports 16,498 33,575,886 1,739 11,969 157 Coastwise 10,865 10,795,006 8 1,376 8 Total 27,363 44,370,892 1,747 13,345 165 SECTION III- CHARACTER OF SHIPPING AND TRADE DURING THE YEAR TABLE C Passenger Traffic Number of Passengers — Inwards 102,557 Number of Passengers —Outwards 108,784 Cargo Traffic Principal Imports All types of produce and merchandise. Principal Exports Principal Ports from which ships arrive. The Port of London trades with all parts of the world. SECTION IV-INLAND BARGE TRAFFIC Numbers and tonnage using the district and places served by the traffic. These barges are of all types and are registered annually with the Port of London Authority. They number approximately 7,000 and their tonnage is some 500,000 tons. The traffic of these crafts extends throughout the length of the Port while a number of them are employed carrying goods and merchandise via the canals to all parts of the country. SECTION V - WATER SUPPLY 1. Source of supply for— (a) The District — No Change (b) Shipping — No Change 2. Pieports of tests for contamination — No Change 3. Precautions taken against contamination of hydrants and hosepipes — No Change. 4. Number and sanitary conditions of water boats and powers of control by the Authority — No Change. QUALITY OF DRINKING WATER SUPPLIED TO SHIPS Probably the greatest single factor affecting the provision of a clean and wholesome supply of drinking water aboard ship is the indirectness of the supply. Except for a rare and accidental overdose of chlorine or some failure in the water mains, the water available at the terminal hydrants is satisfactory and it follows that any deterioration thereafter must be looked for in the conduct of the purveyors, the hoses and fittings and finally in the storage and distribution system aboard. Previous Annual Reports have stressed the concern felt for the quality of drinking water aboard ships and at dock installations which led to the drafting of a "Code of Practice". This was discussed with and agreed by the Port of London Authority and was accepted by other drinking water purveyors including the owners of waterboats. Most of the provisions have now become reasonable established practice and, no doubt, the remainder will eventually be accepted as circumstances and opportunities permit. The "Code of Practice" alone is not a panacea for all deficiencies in the supply — the human factor must make its proper contribution and, to this end, reliable supervision must be maintained. In comparison with the acceptable standards for chlorinated water published by the Ministry of Housing and Local Government in the publication "The Bacteriological Examination of Water Supplies" the results achieved have been very satisfactory and, for the purposes of this assessment, the following grades have been adopted:— Quality Physical Properties — Clear, Colourless, Odourless Plate count per ml CoUforms per 100 ml. Excellent Nil Nil Good < 100 Nil Satisfactory < 300 Nil U nsatis factory >300 W ith 5 Suspicious >300 With >5 U nfit With >5 including faecal coli. 7 Supplies from Waterboats All samples drawn direct from the boats have been examined in all respects and found to be in the "excellent" quality. Distribution aboard ships Of 76 samples drawn from taps in the Accommodation and Galleys 69 were found to be within the "Excellent" — "Satisfactory" qualities. 7 were found to be within the "Unsatisfactory" — "Unfit" qualities. Storage aboard ships Of 18 samples drawn direct from ships' storage tanks 17 were found to be within the "Excellent" — "Satisfactory" qualities. 1 was found to be "Unsatisfactory" quality. Port Installations Dockworkers' drinking fountains were tested on 13 occasions : — 12 were found to be of "Excellent" quality. 1 was found to be of "Satisfactory" quality. Dockworkers' Canteen taps were tested on six occasions and all were found to be of "Excellent" quality. During the year there have been infrequent occasions when drinking water aboard ships has been found so physically impure as to warrant rejection as "Unfit" without recourse to bacteriological examination. The steady improvement in drinking water available to seamen and dockworkers alike in this Port reflects credit on all who have collaborated to this end, and every effort will be made to attain the highest standard possible. FRESH WATER SAMPLE TOTALS & PERCENTAGES - 1960 Dirty Unfit Suspic. Unsat. Satis. Good Excell. 76 Hydrants 0 2 0 6 20 5 43 24 Standpipes 0 0 0 1 5 1 17 84 Hose Ends 7 1 0 19 24 8 25 184 Samples 7 3 0 26 49 14 85 % 3.8 1.6 0 14.1 26.6 7.6 46.2 80.4% FRESH WATER SAMPLES- SUMMARY - 1960 HYDRANTS STANDPIPES DELIVERY HOSE ENDS Dirty Unfit Suspic. Unsat. Satis. Good Excell. Dirty Unfit Suspic. Unsat Satis. Good Excell. Dirty Unfit Suspic. Unsat Satis. Good Excell. STVXOX Victoria Dock 0 0 0 2 4 0 3 0 0 0 0 1 0 1 0 0 0 3 0 2 2 18 Royal Albert Dock 0 1 0 1 5 3 4 0 0 0 1 1 0 0 4 0 0 4 7 2 8 41 King George V Dock 0 0 0 0 2 0 3 0 0 0 0 2 0 1 1 0 0 3 6 1 3 22 Tilbury Dock 0 1 0 3 6 1 17 0 0 0 0 0 1 6 2 1 0 9 8 2 10 67 West India Docks 0 0 0 0 1 1 4 0 0 0 0 1 0 9 0 0 0 0 0 0 0 16 Surrey Dock 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 2 0 0 3 Regents Canal Dock 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 London Docks 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 River Districts 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 1 0 1 7 Isle of Grain Area 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 1 0 9 TOTALS 0 2 0 6 20 5 43 0 0 0 1 5 1 17 7 1 0 19 24 8 25 184 TANKS Water Boats 0 0 0 1 5 0 1 7 GRAND TOTAL 191 8 FRESH WATER SAMPLE TOTALS & PERCENTAGES - 1961 Dirty Unfit Suspic. Unsat. Satis. Good Excell. 51 Hydrants 0 0 2 0 4 2 43 44 Standpipes 0 0 0 0 1 1 42 123 Hose Ends 0 0 2 7 17 14 83 218 Samples 0 0 4 7 22 17 168 % 0 0 1.8 3.2 10.1 7.8 77.1 95% FRESH WATER SAMPLES - SUMMARY - 1961 HYDRANTS STANDPIPES DELIVERY HOSE ENDS TOTALS Dirty Unfit Su spic. Unsat. Satis. Good Excell. Dirty Unfit Suspic. Unsat. Satis. Good Excell. Dirty Unfit Suspic. Unsat. Satis. Good Excell. Victoria Dock 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 4 i 7 18 Royal Albert Dock 0 0 0 0 1 1 12 0 0 0 0 0 0 0 0 0 1 4 6 5 26 56 King George V Dock 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 2 2 4 3 13 Tilbury Dock 0 0 0 0 0 1 13 0 0 0 0 1 1 15 0 0 0 1 3 2 29 66 Surrey Dock 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 9 11 West India Docks 0 0 0 0 1 0 0 0 0 0 0 0 0 -24 0 0 0 0 0 0 1 26 Regents Canal Dock 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 5 7 London Docks 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 1 5 River Districts 0 0 1 0 0 0 2 0 0 0 0 0 0 3 0 0 0 0 0 0 1 7 Isle of Grain Area 0 0 1 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 1 9 TOTALS 0 0 2 0 4 2 43 0 0 0 0 1 1 42 0 0 2 7 17 14 83 218 TANKS Water Boats i 0 0 0 0 0 0 9 9 GRAND TOTAL 227 SECTION VI - PUBLIC HEALTH (SHIPS) REGULATIONS, 1952 1. List of Infected Areas (Regulation 6) — No change. 2. Radio Messages — No change. 3. Notification otherwise than by Radio (Regulation 14(l)(b)) — No change. 4. Mooring Stations (Regulations 22 to 30) — No change. THE PUBLIC HEALTH (SHIPS) AMENDMENT REGULATIONS, 1961 These regulations which came into operation on 17th January, 1961 amend the Public Health (Ships) Regulations, 1952 and 1954. The principal amendments are as follows:— (a) The definition of "excepted port" is extended to include any coastal port in the Federal Republic of Germany or in Italy. Ships coming from excepted ports are not required to comply with certain requirements of the regulations unless the port medical officer considers that compliance is necessary on account of danger to public health. (b) The reference to the International Sanitary Regulations is altered to take account of amending regulations adopted by the World health Assembly since the main regulations were adopted in 1951. (c) The exemption for ships forming part of the armed forces of certain countries is extended to include ships of the armed forces of any Commonwealth country and any other country to which the Visiting Forces Act, 1952, has been applied. 9 CO-OPERATION OF THE THAMES NAVIGATION SERVICE IN PORT HEALTH WORK At 22.30 hours on the 17th April 1961, Dr. P.J. Roden received information via the Thames Navigation Service that the s.s. "Athenic", due to arrive in Gravesend Reach at 03.00 hours on the 18th April from New Plymouth, had an injured seaman on board and that arrangements had already been made for him to be transferred to hospital by ambulance when the vessel reached the Royal Albert Dock. As no other cases of sickness were reported on board, H.M. Customs were asked to give the ship free pratique at once in order not to delay the passage of the ship up the River. This incident again demonstrates the value of V.H.F. radio and the active assistance of the Thames Navigation Service. DENTON HOSPITAL Although Denton Hospital has been taken over by the South East Metropolitan Regional Hospital Board under the National Health Services Act, the Port Health Authority continues to exercise, through Dr. H.M. Vvilloughby, the Deputy Medical Officer, and the Assistant Port Medical Officers, the medical supervision of cases admitted to the hospital. The nursing and administrative control lies with the Dartford Hospital Management Committee. Consultant advice on difficult cases is available through Dr.J. Pickford Marsden, PhysicianSuperintendent of Joyce Green Hospital, Dartford, who whenever necessary transfers cases there for special investigation and treatment. The number of cases admitted to Denton Hospital in 1961 was as follows:— Acne 1 Amoebic Dysentery 2 Chickenpox 19 Chickenpox Contacts 1 Fever of Unknown Origin 2 Infective Hepatitis 3 Influenza 3 Inguinal Adenitis 1 Malaria 2 Measles 10 Measles Contacts 1 Mumps 5 Pneumonia 1 Tonsilitis 4 Tuberculosis, Pulmonary 1 56 SECTION VII - SMALLPOX 1. Name of Isolation Hospital to which smallpox cases are sent from the District. Long Reach Hospital is situated on the south bank of the River Thames about eight miles above Gravesend. The hospital consists of 10 ward blocks capable of accommodating 170 patients but, except in cases of emergency, only three ward blocks (2 of 20 beds and 1, a cubicle ward of 10 beds), total 50 beds, are kept available for immediate use. The hospital includes residential quarters for the staff and a laundry, although the administration and staffing is carried out from Joyce Green Hospital, Dartford. 2. Arrangements for transport of such cases to that hospital by ambulance giving the name of the Authority responsible for the ambulance and the vaccinal state of the ambulance crews. A case or cases of smallpox would be removed from the vessel by this Authority's Ambulance launch and conveyed ashore via the pontoon at Denton and from thence conveyed by road ambulance direct to Long Reach Hospital. The Port Health Authority would be responsible for the vaccinal state of their Ambulance Launch crews, while the vaccinal state of the Road Ambulance personnel would be the concern of the South-East Metropolitan Regional Hospital Board under whose jurisdiction both Joyce Green and Long Reach Hospitals fall. 3. Names of smallpox consultants available. Dr. J.V. Armstrong Dr. H.S. Banks Dr. W.T.G. Boul Dr. W.J. Coughlan Dr. J.P. Marsden 4. Facilities for laboratory diagnosis of smallpox. Facilities are available at the Virus Laboratory at the Central Public Health Laboratory at Colindale. 10 SECTION VDI - VENEREAL DISEASE Venereal Disease is not compulsorily notifiable to Medical Officers of Health but«efforts are made both by the Boarding Medical Officers and the Port Health Inspectors to bring to the notice of seamen using the port the facilities available for free treatment and the importance of obtaining skilled treatment as early as possible. Should there be a known case, it is usually possible to arrange for the patient concerned to be taken at once to the nearest clinic of the Seamen's Hospital or other hospital in the vicinity of the ship. SECTION IX - CASES OF NOTIFIABLE AND OTHER INFECTIOUS DISEASES ON SHIPS TABLE D Category — Cases landed from ships from foreign ports. Disease No. of cases during the year No. of ships concerned Passengers Crew Chickenpox 17 21 26 Dysentery 1 — 1 Fever of Unknown Origin 6 — 5 Gastro-enteritis — 3 3 German Measles 2 2 3 Infective Hepatitis 1 2 3 Influenza — 5 4 Malaria — 2 2 Measles 15 4 8 Miscellaneous 2 10 12 Mumps 6 3 8 Paratyphoid 1 1 2 Pneumonia 3 5 8 Pulmonary Tuberculosis 4 17 19 TOTALS 58 75 104 Cases which have occurred in ships from foreign ports but have been disposed of before arrival. Chickenpox 22 9 19 Diphtheria 1 — 1 Dysentery 10 6 11 Fever of Unknown Origin — 4 4 Gastro-enteritis 31 48 6 German Measles 8 — 4 Infective Hepatitis 1 2 3 Influenza 10 16 4 Malaria 1 7 5 Measles 15 1 8 Miscellaneous 1 1 2 Mumps 17 8 16 Pneumonia 1 2 3 Pulmonary Tuberculosis 1 4 5 Smallpox (suspected) – 2 2 Typhoid — 1 1 Yellow Fever (suspected) — 1 1 TOTALS 119 112 95 Cases landed from other ships. Diptheria ] 1 Fever of Unknown Origin — 1 1 Gastro-enteritis — 1 1 Influenza — 12 3 Miscellaneous — 1 1 Pneumonia – 1 1 TOTALS 17 8 11 SUSPECTED YELLOW FEVER s.s. MACHAON On the 9th June the Medical Superintendent of Alfred Holt & Co. reported that a case of suspected yellow fever had occurred on the s.s. "MACHAON" which was due in London orr the 15th June. The facts, as given, were that a second Steward had reported sick prior to reaching Suez and was seen on arrival there by a doctor who diagnosed Acute Pharyngitis. The patient was allowed to proceed in the ship but his condition deteriorated and arrangements were made for the ship to rendezvous with a German ship which had a doctor on board. The doctor apparently stayed with the patient until he died on the 5th June and gave a certificate indicating that in his opinion the cause of death was suspected yellow fever. The body was subsequently buried at sea. The ship's movements covering the period in question were: Arrived Trincomalee 22nd May — departed 25th May. Arrived Colombo 26th May—departed 26th May. Arrived Djibouti 1st June — departed 2nd June. Arrived Suez 5th June — departed Port Said 7th June. The vessel was due to reach London on the 15th June. As the Weekly Bulletin of the World Health Organisation showed no yellow fever in French Somaliland, it seemed likely that the case was not yellow fever but probably malaria. Prior to the vessel arriving at Gravesend, a radio message was received from the ship reporting also a suspected case of dengue fever in a steward's boy, the symptoms given in the message, however, indicated that this was in fact a case of malaria. The ship arrived in London on the 15th June and from the Captain's notes prepared by the Male Nurse there was little doubt that the first case had died of cerebral malaria and not of yellow fever as we had been led to believe. The second case was found to be one of severe malaria and was at once transferred to Denton Hospital. But for the efficient action of the male nurse on the s.s. "MACHAON", who had promptly administered anti-malarial drugs, this patient would have almost certainly suffered alike fate as the first case. The Medical Officer brought to the notice of the Shipping Company the valuable work of this male nurse who also had the initiative to take a blood smear before giving the anti-malarial drugs and so facilitated early diagnosis as soon as the case was landed. Incidents of this kind again emphasise the advisability of Masters of ships trading with malaria infected ports to keep in mind the vital importance of observing appropriate anti-malarial measures and, in this respect, the Medical Officer was in touch with the Chief Medical Officer of the Marine Crews Division of the Ministry of Transport. The owners of the "Machaon" undertook to instruct all their Masters as to malaria precautions. SUSPECTED SMALLPOX s.s. "CARTHAGE" On the evening of February 11th, the Medical Officer received a telephone call at his home from Dr. Hugh Willoughby, Deputy Medical Officer for the Port, that he had been consulted by one of the Junior Boarding Medical Officers who was on duty that day, about messages received from the P. & O. Line concerning the impending arrival at the United Kingdom of their ship s.s. "Carthage" on which there was reported to be a case of suspected smallpox. The Medical Officer and his Deputy worked out arrangements in this and in subsequent telephone conversations over the weekend, including the obtaining of 1,000 doses of smallpox vaccine from Colindale Public Health Laboratory on the Sunday morning, for transmission by passenger train to Gravesend and collection there by a member of the Port Health Staff, for use if need be when the "Carthage" arrived at Higham Bight (just down river from Gravesend) on the morning of the 13th February. Subsequent events are well reported by Dr. Hugh Willoughby whose account is reproduced below. It confirms the substance of his telephone call to the Medical Officer on the morning of the 13thFebruary at the Ministry of Health,where he was then visiting the Medical Officer in that Department who is particularly concerned with these affairs and who was able to hear over the telephone at first hand from Dr. Willoughby what had been happening. "s.s. Carthage " Message received in 'Hygeia' at 1710 hours on Saturday, 11th February, 1961 from the Medical Superintendent P. & O/Orient Line that this ship had on board a suspected case of smallpox in a Goanese member of the crew. 12 The case was suspicious enough in the mind of the Ship's Surgeon to warrant vaccinating all on board, passengers and crew. 'Operation Brixham' was impractical in view of the shortage of time as the vessel was due at Brixham at 0900 hours Sunday, 12th, and her E.T.A. at Gravesend would be 0600 hours Monday, 13th. I informed the M.O.H. by telephone and outlined the procedure I proposed to adopt. Dr. Marsden, Medical Superintendent at the River Hospital, Dartford, was also informed and the hospital alerted for the possible admission of the case, should it prove to be a 'true bill'. During Sunday, 12th contact was made by the P. 81 O/Orient Line with the ship and the ship was asked to anchor on the Quarantine Ground in Higham Bight on arrival and have an accommodation ladder rigged. M.O.H. Brixham informed me by telephone that the ship had arrived and left Brixham for the Thames at 0930 and that pathological specimens from the patient had been collected and were on their way to London for the Virus Research Unit at Colindale by special messenger. He also stated that he had vaccinated the Channel Pilot and seven Shipping Agents who embarked in 'Carthage' at Brixham. "Voyage Itinerary — Hongkong 13.1.61 Singapore 19.1.61 Penang 20.1.61 Colombo 24.1.61 Bombay 27.1.61 Aden 31.1.61 Port Said 4.2.61 "History of Patient Had been on leave in Goa for 3 months. Joined ship 27.1.61 in Bombay. Re-vaccinated 24.1.61 (3 days before joining) by P. & O. Medical Officer (Dock Staff) which had not 'taken'. On 9.2.61 he found he had some spots on his face which on 10.2.61 had spread to his head, scalp and upper trunk. He did not report sick until a.m. on 11.2.61 by which time the rash covered head, scalp, neck and upper trunk and back with scanty rash on arms and legs. He was apyrexial and has remained so ever since. He was isolated at once in the ship's isolation hospital. "Procedure on Arrival I boarded the ship at 0600 hours, 13th February and interviewed the Ship's Surgeon and saw the patient. " In my opinion he was suffering from Mild Chickenpox. At 0730 hours I was joined by Dr. J. Pickford Marsden and Dr. Edgar of the P. & O/Orient Line plus Mr. Mackie, Mr. Madeley and the Clerical Team from Head Office under Mr. Ratliff. Dr. Marsden confirmed the diagnosis as Varicella and the patient was removed with his bedding and effects to Denton Hospital at 0830 hours. In view of the diagnosis it was not considered necessary to observe the Smallpox procedure of checking the address lists. In fact had we not had a prior alert and had the case been reported on arrival any of your Boarding M.O's. would have carried out routine removal and arranged the usual fumigation arrangements. The Ship's Surgeon had, in this case, played for safety, and was, I feel, somewhat influenced by the opinions of two doctor passengers who saw the patient and remained non-committal on a definite diagnosis. Pratique was granted at 0830 and the vessel proceeded to King George V. Dock with Mr. Mackie and his team carrying out routine fumigation of the Ship's Hospital and the patient's cabin on the way up river. "P.S. Since writing the above report a message has been received at 1015 hours from Colindale saying that the Complement Fixation Test, on specimens sent from Brixham, is NEGATIVE". (Sgd.) HUGH WILLOUGHBY. 13 The Medical Officer considers that Dr. Willoughby and the Port Health Staff concerned are deserving of congratulations for the action taken over this incident, and Dr. Willoughby for his report upon it. The egg culture test was also reported negative from Colindale. The two negative laboratory tests were to have been expected in view of the clinical diagnosis of chickenpox and not smallpox. SUSPECTED SMALLPOX s.s. "STRATHNAVER" The following is an extract from the Weekly Epidemiological Record of the World Health Organisation for the 30th March, 1961: "s.s. "STRATHNAVER" from Bombay via Aden arrived at Suez on 25th March with one case of modified smallpox amongst the crew. Vessel is scheduled to arrive on 29th March at Marseilles and on 4th April at London." Prior information to this effect had already been received from the P. & O./Orient Line on the 25th March and confirmed by the Ministry of Health. It was, therefore, deemed necessary to execute "Operation Brixham". The vessel was boarded by Port Health Staff on the 3rd April. All passengers and crew were inspected and their names and addresses obtained for subsequent notification to local Medical Officers of Health. No further case occurred during the voyage and the ship berthed at Tilbury Landing Stage on the 4th April without delay. Detailed Report An interesting account of the incident is reported by Dr. H. Willoughby, as follows : — " s.s. "STRATHNAVER". This vessel landed a case of "modified smallpox" at Suez on the 25th March, 1961, which was diagnosed clinically by the Egyptian Port Health Authority. Before the vessel arrived in the United Kingdom this diagnosis was confirmed by the World Health Organisation and the Ministry of Health. It was therefore decided to alert "Operation Brixham" in view of the fact that any secondary case might well be incubating the disease on the day prior to arrival in London when close scrutiny of the personnel might well reveal a case exhibiting the prodromal symptoms. It was unfortunate that the arrival date at Brixham coincided with the Easter Holidays when communications were liable to disturbance and rail and road services were also less reliable than normal weekly services. Accordingly Dr. H. Willoughby (Deputy Medical Officer of Health), Dr. W.T.G. Boul (Consulting Physician), Dr. B. Edgar (Medical Superintendent, P. & O./Orient Line), Mr. T.L. Mackie (Chief Port Health Inspector) and Messrs. Ratliff, Stout and Smith (Administrative Officers) proceeded to Brixham on Easter Sunday, 2nd April, to await the arrival of the "STRATHNAVER" in Brixham Roads. We boarded the vessel at 1430 hours on Easter Monday, 3rd April, and immediately held a conference with the Senior Medical Officer of the ship. "Voyage Itinerary Left Sydney on 26.2.61; Melbourne 1.3.61; Adelaide 2.3.61; Fremantle 6.3.61; Colombo 14.3.61; Bombay 17.3.61; Aden 21.3.61; Suez 24.3.61; Marseilles 30.3.61; Brixham 3.4.61; Tilbury arrived Noon 4.4.61. "Case History Paul d'Silva, aged 44, a Goanese Scullion, joined the vessel in Bombay on the 17th March, 1961 having been in that city "for a few days". On the 23rd March he was brought to the Sick Bay by the Head Cook with a skin rash. (Note: Patient was brought to the Sick Bay and did not report of his own volition). He did not complain of feeling ill although he had in fact a temperature of 100°F. He had a profuse skin eruption, vesicular in nature on the head, face, chest and back. Few lesions were present on thighs and legs, a few lesions (about 3 in number) on the palate and few in each axilla. Nil on palms of hands or soles of feet. He admitted to having a slight headache. The skin lesions were superficial rather than deep and a few were lenticular in folds of the abdomen. There was no evidence of "cropping". 14 He was vaccinated on the 14th March, 1961 in Bombay, but had no evidence of such recent vaccination. Two good marks of previous vaccination were present. He was an old servant of the P. & O. and there is therefore strong presumptive evidence that he had been well vaccinated in the past. Before landing he was seen by two doctor passengers (both Asian), one of whom diagnosed Smallpox and the other Chickenpox. In view of this divergence of opinion, the Ship's Surgeon and Assistant Surgeon revaccinated the entire ship's company and all the passengers on the 23rd and 24th March —a most commendable action in view of the fact that there were 1,480 people involved (Crew 504, Passengers 976). There were, remarkably, no conscientious objectors. On arrival at Suez the case was seen by the Duty Port Medical Officer and by a Dr. Hanna, who came over from Cairo to see the case, and the patient was removed to hospital as suffering from "Modified Smallpox". "Disinfection: The patient's bedding from the Ship's Hospital was removed for fumigation at Suez, but not the unused bedding from other cots in the hospital. Bedding in Peak 72 occupied by the patient — sheets and pillow cases —was steeped in Lysol on board. The pillows and mattress were not dealt with. "Procedure on Boarding at Brixham It was considered that the case was infective from the 22nd March. Those at risk were:— "Priority 1 Nine others occupying Peak 72. These were stripped and closely scrutinised by Dr. Boul who took each man's temperature and examined closely for evidence of previous Smallpox or Chickenpox. "Priority 2 Co-workers in Ship's Galley, totalling 20 Europeans (Cooks etc.), and 40 Asians, mainly scullions and food handlers. These were similarly examined and all found to be in good health. "Priority 3 Passengers, Deck Crew and Engine Room Crew. All remote risks. These were inspected at muster and home addresses checked and cross-checked. All were found to be in good state of health except four crew members who had, in two cases, septic skin lesions, and two who appeared anaemic. These four were remustered on arrival at Tilbury and dismissed as non-infectious ailments. "Bedding: Mr. Mackie assumed control of environmental conditions and organised the fumigation of the ship's hospital and Peak 72, and the removal to Denton Isolation Hospital of all bedding and soft furnishings for steam fumigation from both the ship's hospital and the peak in question. "Conclusions "(1) From the clinical evidence —and in the absence of the patient —it would appear to have been a case of Chickenpox. Evidence of this lies in " (a) Absence of prodromata with so profuse an eruption (i.e. at least 400—500 lesions). "(b) Distribution of rash. "(c) Diverse shapes of lesions. "(d) Low temperature (100°F) relative to extent of eruption. "(e) Vaccinal state. and, finally, Negative reports from Colindale Laboratory — both Complement Fixation Test and Egg Culture —on specimens sent by air for laboratory tests. " In view of the number of persons involved this was probably one of the most extensive exercises that the Port of London Health Authority's "Mobile Fire Brigade" has hitherto indulged in. " Had the vessel been boarded at Tilbury instead of Brixham one could estimate a delay of at least 8 — 9 hours before the ship could have docked. (Advanced information was sent by radio to the "Hygeia" and the ship berthed without restriction according to schedule.) 15 In the present instance it took the entire team from 3 p.m. to midnight to examine everybody and check the destination lists etc. Our three administrative assistants had to be augmented by two Assistant Pursers to keep the queue moving rhythmically and to keep up with the two Immigration Officers. Luckily an Assistant Purser had had previous experience of our activities, and had organised the passengers in advance into six parties of 150 each to avoid delay and annoyance to them. This was most commendable and also enabled meals to be served with the minimum of delay — a consideration when two sittings for each meal were involved plus our examination of the stewards and cooks. I cannot speak too highly of the co-operation and cheerful services rendered by our team who worked well into the night and appeared next morning so cheerfully to pick up the "Wefts and Irish Pennants" left over from the previous night's activities. To Dr. Boul I also tender most grateful thanks. With great goodwill he weighed in and assisted in the examination of all on board, work far beyond his consultative duty which more than halved the time it would otherwise have needed." As soon as the "STRATHNAVER" had arrived at Gravesend, the administrative team were landed and proceeded immediately to the Central Office. The names and addresses of passengers were then forwarded to the local Medical Officers of Health the same evening. Names and addresses of members of the crew who were due to leave the ship were also similarly notified. Changes of address continued to be forwarded to Medical Officers until the 7th April when the incubation period expired and the danger of secondary cases was considered at an end. SECTION X - OBSERVATIONS ON THE OCCURRENCE OF MALARIA ON SHIPS Ten cases of Malaria (9 seamen and one passenger) were reported on ships during the year under review. This compares with twelve cases in 1960. The one passenger and five seamen were well on arrival. Two seamen were admitted to Denton Hospital and the Seamens Hospital at Greenwich respectively. One was landed to hospital in Freetown and one died at sea. A notice giving advice on the Chief Precautions and Treatment of Malaria is issued by the Ministry of Shipping and should be on board every British ship. A text of this notice was reproduced in the Medical Officer's Annual Report for 1958. MOSQUITO CONTROL AT ISLE OF GRAIN During the period 13th March to the 14th of October, mosquito control was carried out within the perimeter of the B.P. Refinery, comprising of 700 acres plus an additional area of 210 acres of the Ex. R.N.A.D. land adjacent which B.P. have acquired. The actual field work was carried out by the same "Mosquito Control Operator" attached to the Refinery Medical Department who was employed the previous year on this work. This is of great benefit as no delay is experienced in training new personnel and becoming familiar with the area before commencing treatment. Weekly meetings have been attended with the Refinery Medical Officer and the operator so that a high standard of control has been maintained. This was achieved by larvicidal treatment with dieldrin and, because of the dry period at the beginning of the season which eliminated many of the temporary pools, the operator maintained the three week cycles of the whole area, even with the extra acreage, without difficulty. This year no anopheles were discovered, the most common species being Aedes detritus, Aedes caspius, Theobaldia annulata and Culex pipiens. A start has been made by the Army to level the gravel pits adjacent to Grain Village, which had been advocated by the Malaria Reference Laboratory for some years. These pits have been a prolific breeding ground and, though work has not been completed, a noticeable improvement has occurred. 16 SECTION XI - Measures taken against ships infected or suspected of Plague The Fourth Schedule to the Public Health (Ships) Regulations, 1952, under the heading "Additional measures in respect to the quarantinable diseases" — Part I — Plague, reads as follows "(1) The Medical Officer may — (a) require any suspect on board to be disinsected and place him under surveillance, the period of surveillance being reckoned from the date of arrival of the ship} (b) require the disinsecting and, if necessary, disinfection of the baggage of any infected person or suspect, and of any other article on board and any part of the ship which the medical officer considers to be contaminated. (2) If there is rodent plague on board, the medical officer shall require the ship to be deratted in a manner to be determined by him, but without prejudice to the generality of this requirement the following special provisions shall apply to any such 'teratting — (a) the deratting shall be carried out as soon as the holds have been emptied; (b) one or more preliminary derattings of the ship with the cargo in situ, or during its unloading, may be carried out to prevent the escape of infected rodents; (c) if the complete destruction of rodents cannot be secured because only part of the cargo is due to be unloaded, a ship shall not be prevented from unloading that part, but the medical officer may apply any measure which he considers necessary to prevent the escape of infected rodents." Plague being primarily a disease of rats all vessels are inspected immediately on arrival at their berths in the docks and river for the presence of any mortality among the rats on board which is not attributable to any known cause, such as trapping, poisoning, etc. Incidentally one of the "Health Questions" on page 1 of the "Maritime Declaration of Health" requires the Master to answer "Yes or No" to the question "Has plague occurred or been suspected amongst the rats or mice on board during the voyage, or has there been an abnormal mortality among them?" Any dead rats are immediately sent to the Central Public Health Laboratory at Colindale for examination for bacillus pestis, each rat being accompanied by a label on which is given precise information as to where the rat was found in order to arrive at a focus of infection should the examination prove positive. The information is, of course, far more vital when the rat has been found ashore than when found on board a ship. In the event of a positive result the "additional measures" referred to above would be put into operation — the discharge of the cargo would be promptly stopped and arrangements made for the vessel to be fumigated throughout with hydrogen cyanide, with the cargo in situ, the vessel being moved to an approved mooring. Following the initial fumigation and collection of dead rats resulting therefrom, further samples of such rats would be submitted for examination and the discharge of cargo would be permitted under observation. The destination of the cargo would be forwarded to the Medical Officer of Health of the district to which it was proceeding, together with an explanatory note. If any of the cargo had already been discharged overside into lighters before the discovery of plague infection, the lighters would be fumigated immediately. On completion of the discharge of cargo from the vessel a second fumigation would be carried out, again using hydrogen cyanide, to destroy the residual rat population, if any. SECTION XII—Measures against rodents in ships from foreign ports (1) Procedure for inspection of ships for rats. The Port Health Authority employs sixteen Rodent Operatives working in conjunction with and under the supervision of the Port Health Inspectors. The Rodent Operative's first duty is to visit all ships arriving in his district to search for evidence of rodents, paying particular attention to vessels which have arrived from plague infected ports and to visit such vessels during the discharge of cargo and to ascertain that reasonable measures are adopted to prevent any rodents escaping ashore. 17 His second duty is the examination of ships in his area which are due for inspection under Article 19 of the Public Health (Ships) Regulations, 1952, and the Prevention of Damage to Pests (Application to Shipping) Order, 1951-6, relating to the granting of Deratting and Deratting Exemption Certificates and Rodent Control Certificates respectively. The Rodent Operative's third duty is the examination of shore premises for signs of rat infestation paying particular attention to premises adjoining the berths of vessels from plague infected ports. Some twenty years ago the Port Health Authority instituted a Rodent Control Scheme in all docks and premises of the Port of London Authority on behalf of that Authority and in the premises of the tenants of the Authority on behalf of the occupiers. (2) Arrangements for the bacteriological examination of rodents, with special reference to rodent plague , including the number of rodents sent for examination during the year. As described in Section XI above, all rats for examination for plague, either by post mortem and subsequently, if necessary, by bacteriological examination, are promptly sent to the Central Public Health Laboratory at Colindale. The bodies are placed in polythene bags which in turn are placed inside metal boxes, sealed and labelled so that there is no risk of the escape of any rat fleas during their transit to the Laboratory. The boxes are, of course, delivered by hand. The rat population of the Port is now so small and is under such strict control that it can be said to be almost certain that the arrival of a plague infected rat, even should it manage to get ashore, would be highly unlikely to have any serious significance. In other words, an epizootic could not be introduced into the Port for the simple reason that there are insufficient rats to enable the spread of infection. Nevertheless, eighty-one rats were sent to the Laboratory and were examined for plague with negative results. (3) Arrangements in the district for deratting ships, the methods used, and if done by a commercial contractor, the name of the contractor. (a) The burning of sulphur at the rate of 3-lbs. per 1,000 cubic feet of space for a period of not less than six hours. (b) The generation of hydrocyanic acid gas by various methods. For the destruction of rats a concentration of HCN at the rate of 2-ozs. per 1,000 cubic feet of space is required with a minimum of two hours contact. (c) "1080" and "Warfarin". The employment of "1080" has been used regularly throughout the docks for some time with highly satisfactory results both on shore and in ships. A substantial number of ships have been deratted by this method in preference to the use of cyanide, resulting in a considerable saving of time and cost to the shipowner. Although satisfactory results have been obtained from the use of "Warfarin" a suitable bait has yet to be found, particularly in granaries, with which to mix the poison, so that rats will take it continuously in preference to grain and other forms of cereal on which they are normally feeding. (d) Trapping. Trapping is seldom employed save for the destruction of isolated rats which have escaped a major poisoning operation or which have not yet established themselves. (e) Methyl Bromide. This is a very effective and lethal fumigant which has been used in this Port as an insecticide, particularly in the dry fruit industry. It has considerable penetrating powers and is not difficult to disperse after an operation. It is also possible to use this gas as a rodenticide and where there is an infestation of rodents and insects the combined problem can be solved with one operation. The following are the names of the firms approved for carrying out the deratting of ships:— Messrs. Associated Fumigators Ltd. Rentokil Laboratories Ltd. Messrs. London Fumigation Co. Ltd. Contra-Pest Service Ltd. The P. & 0. Orient Line GENERAL OBSERVATIONS ON RODENT CONTROL In any form of organised rodent control there will always be a measure of urgency; there is need for intelligency, technical skill and persistent effort if the wiles and tenacity of rodents are to be overcome, a need which is all the greater in a major seaport such as this, with its complex pattern of international commerce involving numerous ships, harbour craft, shore premises and transport vehicles ; control must also be exercised with the minimum of obstruction to the trade of the port. 18 In previous Annual Reports details given of the Port of London Rodent Control Scheme have referred to operational techniques, rodenticides, selection and examination of specimen rats and rodent-proofing ashore and afloat. The methods adopted have proved satisfactory and, apart from minor improvements, will be generally continued until circumstances necessitate a change. No particular incident has arisen during the year requiring other than the normal vigilance and activity necessary to obviate any threat of rodent-borne communicable diseases entering or leaving the Port or any undisturbed centre of infestation on harbour craft and shore premises. Of course, the control of rodents aboard sea-going ships is intimately linked with these safeguards too. It was observed, however, that during the unusually mild weather of the winter months the rate of breeding and activity amongst both rats and mice was abnormal. This was particularly shewn on lighters by the increase of rats destroyed in that period. In spite of satisfactory control throughout the Port, investigation continues with a view to the introduction of better methods and organisation. Much is written and spoken about the most suitable poisons but not so much emphasis is laid on the bait base which is very important, for it is, surely, the bait base which must attract the rodents quite regardless of the poison used. It is at this point that practice in a busy seaport and that of hinterland organisations differ. In a seaport such as London there is inevitably a wide variety of rodent-attractive food in and around the warehouses, some of which is stored for considerable periods of time and some transported at relatively very short notice from one place in the Port to another equally vulnerable site. The most effective control, therefore, demands a baitbase which is almost irresistible to rodents, e.g. drinking water for rats, alone or absorbed in a cereal, while mice, which need less water and are much less predictable in appetite and behaviour, must be lured by a baitbase which is more attractive than other foods which may be available to them. Of poisons there is a range of choice to meet particular circumstances. In this Port the choice is made with the object of rapid extermination in the joint interests of public health and trade without however disregarding the humane aspect of these vital operations. Mice infestations can be very difficult to eradicate, particularly when transported as passengers with imported agricultural cargo. Some cargoes from the Continent are particularly vulnerable and must be constantly viewed with suspicion. Increased agricultural imports resultresulting from possible entry into the Common Market will accordingly require added vigilance. Rodent proofing has been adopted on dock premises and vessels whenever possible, and Senior Rodent Inspector Stimson reports considerable modifications on lighters during the year. Precautions against the establishment and spread of rodent-borne diseases have continued by submission of dead rats for clinical and bacteriological examination, the specimens representing a complete cross section of association with Port and commercial activities. Correspondence between this and other large seaports has been maintained to co-ordinate efforts of rodent control aboard ships. This practice is now spreading and finding favour with some continental ports to mutual advantage. It is encouraging to learn that the numerous visitors to the Port whose particular interest is in rodent control pay tribute to the standard of efficiency of the staff and of the measures in operation. RODENT CONTROL ON LIGHTERS Year 1961 Average for 5 years Number of lighters inspected 6,366 4,450 Without recent evidence of rats 5,475 (84.9%) 85.1% With negligible evidence of rats 859 (13.5%) 11.6% Treated for evidence of rats 32 (1.6%) 3.3% Dead rats recovered after treatment 848 754 Average dead rats per Lighter 8.1 7.7 PREVENTION OF DAMAGE BY PESTS (APPLICATION TO SHIPPING) ORDERS 1951-56 Since 1951 the Port Health Authority has been issuing Rodent Control Certificates to coastwise shipping as provided for by the terms of the Prevention of Damage by Pests (Application to Shipping) Order, 1951. During the year 1961 the Port Health Authority issued 32 such Certificates. 19 TABLE E Rodents destroyed (bodies recovered) during the year in ships and in shore premises (l) On vessels Number of Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Black Rats 240 204 591 309 165 112 196 247 314 171 191 63 2,803 Brown Rats – 3 — — 5 — — — — _ _ — 8 Rats examined 12 5 17 8 10 1 12 8 10 6 5 3 97 Rats infected with plague — — — — — — — — — — — — — (2) In Docks, Quays, Wharves and Warehouses Number of Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total Black Rats 58 51 92 53 98 145 98 105 169 88 65 87 1,109 Brown Rats 136 35 61 26 61 81 101 48 67 92 54 54 816 Rats examined 3 2 3 2 2 5 2 — — 2 3 — 24 Rats infected with plague – – – – – – – – – – – – – Mice: 3,404 mice were also destroyed; 675 in ships and 2,7 29 in shore premises. TABLE F Deratting Certificates and Deratting Exemption Certificates Issued during the Year for Ships from Foreign Ports No. of Deratting Certificates Issued Number of Deratting Exemption C ertificates Issued Total Certificates Issued After Fumigation with After Trapping After Poisoning Total HCN Other Fumigants 1. 2. 3. 4. 5. 6. 7. "Sulphur Dioxide" 12 1 NIL "1080" .91 104 964 1,068 20 SECTION III — Inspection of Ships for nuisances TABLE G Inspections and Notices No. of Vessels Number of vessels visited by Port Health Inspectors 14,042 Number of vessels on which sanitary defects were found, and details reported to the Master, Owners and/or Ministry of Transport 633 Number of Statutory Notices served Nil Number of vessels on which sanitary defects were remedied 630 Summary of Structural and other Defects Inadequate ventilation 3 Defective Lighting — Natural _ Do. Do. — Artificial 1 Defective or Insufficient Heating 3 Condensation. 2 Leaking Decks 4 Leaking Ports, Decklights, etc. 7 Leaking Sideplates 2 Leaking Hawse or Chain Pipes _ Defective or Obstructed Floor Drainage 28 Water Lodging on top of Peak Tanks _ Defective Bulkheads 3 Do. Floors 28 Do. Doors 4 Do. Chain Pipes Do. Bunks Do. Clothes Lockers. 1 Do. Food Lockers 10 Do. Food Storage 35 Do. Cooking Arrangements 48 Defective or Uncleanly Drinking Water Storage 3 Water Closets — Obsolete 6 Do. — Defective 39 Do. — Foul or Choked 21 Do. — Inadequate Flush 16 Wash Basins — Defective 17 Do. — Foul 5 Neglected Paintwork or Distemper. 22 Absence of Washroom Absence of Messrooms 1 Misappropriation of Crew Spaces 2 Verminous Quarters 238 Dirty Quarters 416 Miscellaneous 98 T otal 1,063 SECTION XIV — PUBLIC HEALTH (SHELLFISH) REGULATIONS, 1934 The Public Health (Shellfish) Regulations, 1934, confer powers on a local authority whereby on receipt of a report of their Medical Officer of Health that the consumption of shellfish taken from a laying is likely to cause danger to public health, they may make an Order prohibiting the distribution for sale for human consumption of shellfish taken from the laying either absolutely or subject to such exceptions and conditions as they think proper, having regard to the interests of the public health. Two such Orders have been made. The first in 1936, covering the public and private layings bordering that part of the foreshore of the Estuary of the River Thames between Canvey Island and Shoeburyness ; and the second, in 1957, covering the foreshore or waters bordering on that part of the Estuary of the River Thames or any tributary thereof, between Garrison Point, Sheerness, and Warden Point in the Isle of Sheppey. No cases were reported during the year of food poisoning or other illness resulting from the consumption of shellfish taken from layings within the district of the Port Health Authority. OYSTERS IN RIVER ROACH AND AT BARLING HALL CREEK The situation here has remained basically unchanged during the year. There has been no instance of polluted shellfish or polluted layings, but one is ever conscious of the increasing population of the surrounding area and the possibility of pollution being introduced to the oyster beds. 21 Much of the River Roach is worked by shellfish companies who use the Roach as a growing area and transplant their oysters to some other vicinity for fattening and marketing. An exception is Keeble Bros, of Paglesham whose oyster beds are mainly outside the district of the Port of London Health Authority but who bring their oysters to Paglesham — within the Authority's area — to be sorted and graded and stored in oyster pits at Paglesham in preparation for sale. Keeble Bros, are a comparatively small 'family' firm who deal mainly in high class Natives and who have definite old-established outlets for their oysters. So far as is known they have never had any trouble with pollution. Theirs is essentially a winter trade. Another firm which markets from within the Port Health Authority's district is the Essex Oyster Co. at Barling Hall Creek. In contrast to Keeble Bros., the Essex Oyster Co. work mainly with Portuguese oysters for the summer trade at Southend-cn-Sea. The Company has been in existence for many years, and, in addition to the layings in Barling Hall Creek, has some oyster beds in the River Roach. At their Depot at Barling Hall Creek there is a concrete barge which has been modified and adapted for use in storing the Portuguese oysters which have been graded and are ready for sale. If this storage is performed intelligently it can be an important factor in ridding oysters of any possible pollution they may have retained from the creeks. But as Barling Hall Creek and the River Roach are not "prohibited areas"the Port Health Authority have no reason to insist on "cleansing" or to supervise any voluntary cleansing which may take place. During 1961 Mr. P.C. Wood of the Fisheries Laboratory, Ministry of Agriculture, Fisheries and Food at Burnham-on-Crouch has made a significant advance in the technique of purifying oysters by completing his investigation into the use of Ultra-violet Light for sterilising sea water. Using apparatus which Mr. Wood has devised it is now possible to instal and run quite cheaply a small oyster purification plant suitable for individual producers. There is such an apparatus at Billingsgate which uses artificial sea water and which is giving very satisfactory results. There is another experimental apparatus of earlier design at Barling Hall Creek which has not so far been brought up-to-date and on which there are no recent data. In other parts of the country there are several of these new small plants. THE COCKLE INDUSTRY AT LEIGH-ON-SEA Since the outbreak of food-poisoning in 1949 which was partially attributed to cockles, the Cockle Industry at Leigh has been gratifyingly free from troubles. The Industry received much attention from the Port Health Authority and the County Borough of Southend-on-Sea in 1949 and the years immediately after. The methods of cooking the cockles, and the subsequent washing, were investigated and improvements were suggested. The personnel were lectured and trained in hygiene, and in all these matters the industry co-operated whole-heartedly. The improvements made at that time have been generally maintained. In many of the Establishments the hygiene is very good indeed. There remains,— as always in an Industry such as this — a hard core of "old timers" who will resist changes and improvements, and with these it is still necessary from time to time to apply pressure in order to maintain the standard achieved. Samples of Cockles, cooked, washed and ready for sale are taken regularly by the Public Health Department of the County Borough of Southend-on-Sea for bacteriological examination. The Port Health Authority's Order dated 25th July 1957 restricting the gathering of shellfish on the South side of the Estuary has had the effect of eliminating the casual shellfish processors who formerly operated with primitive equipment on the Kent shore. Cockles are still from time to time collected from the "prescribed area" but they are brought to Leigh where they are sterilised in approved apparatus in accordance with the provisions of the Order, and they have caused no trouble. SECTION XV-MEDICAL INSPECTION OF ALIENS 1. List of Medical Inspectors of Aliens holding warrants of appointment on 31st December, 1961. Dr. J.Greenwood Wilson, Dr. H.M. Willoughby, Dr. J.A. Jones, Dr. D.T. Jones, Dr. P.J.Roden, Dr. D.J. Avery, Dr. J.B. Maguire, Dr. J.O. Murray, Dr. W.T.R ougie r Chapman. 2. List of other staff engaged on the work. Clerical staff at the Central Office. 22 3. Organisation of the work. All vessels carrying aliens are are intercepted on arrival in the Port and the aliens are examined by the Medical Inspector of Aliens who is, in fact, the Boarding Medical Officer on Duty. Complete liaison exists between the Port Medical Staff and the Immigration Staff at Gravesend and should any doubtful cases arrive, the Medical Inspector is immediately communicated with by telephone and an opinion given. The Boarding Medical Officer is assisted by a panel of part-time Medical Inspectors. 4. Nature and amount of alien traffic. (a) Total number of arriving vessels carrying aliens 2,973 (b) Total number of aliens (excluding transmigrants, seamen and airmen) — (i) Arriving at the port 36,028 (ii) Medically inspected 15,127 (iii) Medically examined 229 (c) Certificates issued 3 (d) Transmigrants landed and medically inspected Nil 5. Accommodation for medical inspection and examination is provided on Tilbury Landing Stage, though in practice, the majority of aliens are inspected in the ship on arrival and any necessary chaperonage is provided by nursing sisters or stewardesses borne in the ship. SECTION XVI-MISCELLANEOUS Arrangements for the burial on shore of persons who have died on board ship from infectious disease. The body of any person dying on board ship, or in Denton Hospital, from infectious disease would normally be removed from the ship or Denton Hospital for burial by a Private Undertaker acting on the instructions of the shipping company or the next-of-kin, the local police being kept informed. In the event of the death being due to smallpox, special instructions as to precautions to be taken would be given to the undertaker by the Port Health Authority. FOOD INSPECTION The total amount of foodstuff seized and condemned as unfit for human consumption and either reconditioned or disposed of for animal feeding or manufacturing purposes under guarantee or destroyed was 3329 tons 5 cwts. 3 qrs. 20 lbs. The following is a summary showing the method of disposal of the foodstuffs concerned:— Method of disposal Weight Comparable Weight 1960 Burnt 66 2 0 15 270 15 3 7 Buried 2513 7 2 7 2333 4 0 5 Boiling down 61 17 1 27 90 6 1 17 *Animal feeding 176 0 1 19 129 9 0 11 *Refining 93 17 2 11 396 11 0 0 *Released to other districts 299 6 3 0 75 11 0 18 *Manufacturing etc. purposes 61 19 1 7 160 14 0 9 Re-exported 56 14 2 18 55 0 0 10 3329 5 3 20 3511 11 2 21 Items marked * were released with agreement of and under the supervision of local Medical Officers of Health. Of the 3329 tons listed above the principal items and methods of disposal were as follows:— Burnt Tons cwts. 546 cartons and cases and approx. 5133 cans fruits, juices, pulps, vegetables, meats and fish 22 0 Qty. ship's rejected stores 3 14 Qty. meat and offal and meat products 14 53 bags figs — rat damaged 14 Qty. fresh fruit — wasty and sweepings 6 0 31 ctns. currants — dirty 8 881 bags and baskets vegetables and qty. loose collected — wasty 11 19 300 pkgs. green tea — excess lead 16 2 23 Buried Tons cwts. 1611 cartons and cases and approx. 14715 cans fruits, juices, pulps, vegetables, meats and fish 66 12 29520 bags onions and qty. loose collected — wasty 342 0 Qty. bananas and banana waste — wasty 1620 6 423 boxes and ctns. dried fruit — infested and dirty 8 6 718 baskets potatoes — wasty 18 3 436 half baskets tomatoes — wasty 3 0 3430 casks and crates fruits and pulps — wasty and out of condition 37 12 12 bags Egusi — salmonella contamination — 9 28 crates and qty. loose collected yams — wasty 6 0 Boiling down Qty. carcase meats and offal — various reasons for condemnation 61 17 Animal feeding 24 b/in crops and hinds — no official cert. 1 0 890 cases and bags nuts — dirty, sweepings and infested 31 6 70 bags pea sweepings 3 18 56 bags rice sweepings 1 15 244 boxes dried fruits — dirty and infested 2 19 232 bags dried milk powder — wet damaged 9 11 2308 bags flour — wet damaged 120 3 Qty. ship's rejected stores 3 0 30 ctns. beef patties — scrap meat - 12 Refining 812 bags sugar sweepings 93 17 Other districts 61 chests and qty. loose collected tea — wet and dirty 38 15 1214 ctns. lard — oil damaged and dirty 16 3 66 pkgs. butter — dock water damaged and dirty 1 15 1729 cases and bags ox livers — diseased (for 100% examination) 56 10 483 ctns. egg albumen — salmonella (for heat treatment) 12 1 230 bags onions — wasty 5 15 1425 cases pears — overripe 35 12 100 bags desiccated coconut — salmonella 5 0 1990 bags flour — wet damaged 115 17 Manufacturing 53 carcases meat — ship's rejected stores 11 200 casks plum pulp — excess preservative 57 15 204 ctns. lard — heat damaged and dirty 3 2 Re-exported 100 c/s confectionery — wet damaged 2 13 16 kegs nutmegs — infested 1 0 598 ctns. beef tongues — no official cert. 16 8 70 bags Desiccated Coconut — salmonella 3 2 255 bags tea sweepings 25 1 200 chests tea — excess lead content 1 12 23 casks casings — no official certificates 4 18 Qty. dried apricots — excess preservative 1 5 is made to them for their help. They cover the same period as this report and are figures of tonnages of foodstuff landed on their quays and handled by them during this period. Commodi ty Tons Butter, cheese and margarine 18,425 Canned goods 103,184 Flour 43,396 Fruit, dried 29,332 Fruit, green and vegetables 323,615 Grain and seed 142,029 Meat, chilled and frozen 477,057 Other provisions 31,025 . Sugar 25,057 Tea 24,510 1,217,630 24 Goods which are re-exported are notified to the Medical Officer of Health of the area to which they are going except in the cases of lack of official certificates. The following figures have been given by the Port of London Authority and acknowledgement is made to them for their help. Taking the total weight of items in the first table as 3,329 tons, the amount dealt with expressed as a percentage of imports for the period equals 0.27%. (Figures for 1960 not available). Tea Sampling During the period covered by this report 3,093 samples were drawn and examined. Of these 34 were unsatisfactory, and arrangements were made to dispose of the consignments involved, either by blending with other teas to reduce the lead content or for export. NIGERIAN AND WEST AFRICAN FOODS During the course of the year consignments of Yam Flour, Ground Egusi (crushed melon seeds), Gari and crushed Bitter Leaves have been arriving in the docks. They are intended primarily for sale to the increasing number of Nigerian and West African immigrants in this country and for whom they are part of their normal diet. Samples were drawn as a matter of routine and salmonella contamination was found in the Bitter Leaves and Ground Egusi. All further shipments of these goods were detained pending information as to use and also the extent of contamination. The uses are varied and may be of general interest. The Bitter Leaves may be used whole in the same way as we would use spinach or chopped as we would use mint. Egusi is used as a flavouring agent in cooking or as a thickening agent. Gari is Cassava flour resembling tapioca and is presumably used as such. Yam Flour is what its name implies. The bacteriological picture obtained indicated that the Yam Flour, Gari and Bitter Leaves were generally satisfactory and imports were released unconditionally. The Ground Egusi was not satisfactory and all imports were detained and sampled until action taken at source was reflected in more satisfactory results of bacteriological examination. However, a further complication presented itself from the point of view of fitness for human consumption. The Public Analyst reported that in his opinion samples of some of these goods appeared to be in various stages of rancidity and would be considered unfit for human consumption in this country under the Food and Drugs Act for sale to the white population, but would probably be quite acceptable to the nationals to whom it was a normal item of food. As it is obviously impossible to apply two standards of fitness for the same food the problem was resolved by assuming that only those to whom these foods were acceptable would wish to purchase them and they would not then be sold "to the prejudice of the purchaser". A further complication has arisen in that another food — Guinea corn — has frequently contained ground insects and investigations are being made to see if this is a necessary ingredient. It is appreciated that the Englishman would perhaps never buy these articles of food but the law sets a standard, regardless of national tastes, and here perhaps is an example of where common sense and compromise must be put to good use. It is, however, an interesting thought to take this one stage further and ask what else will happen to puzzle us if we join the Common Market where all laws eventually must be approximated. What standards do we apply then? EGYPTIAN ONIONS One of the problems associated with the control of foodstuffs in the Port of London is the arrival of "seasonal" perishables and especially the importation of Egyptian onions. The majority of the onions arrive at the India Dock Group but the problem of sorting a deteriorating cargo is one which applies at various times to all docks. Owing to the perishable nature of the cargo and the speed with which decomposition is accelerated with inadequate ventilation during transit and inadequate storage facilities after landing, the sorting operation of a whole shipment is impracticable on the dock. Every endeavour is made to avoid unnecessary condemnation of foodstuffs, and in cooperation with the trade it is practice to release for sorting with the further agreement of the local Medical Officer of Health, shipments to areas where such operation can be conveniently effected thus relieving the available port accommodation of congestion. Some idea of the magnitude of this problem is obtained from the fact that during the "season" approximately 12,000 tons of onions were imported into the Port of London. 372 tons of these onions were destroyed on importation. The remainder consisting of more than 11,000 tons were released to local authorities for sorting. It is of course impossible for the Medical Officer of Health to state how many of these onions were finally released for human consumption. 25 IMPORTED CHEDDAR CHEESE Investigation of the bacteriological condition of imported cheese of various origins was, early in the year carried out in the Port of London involving the examination by the Public Health Laboratory Service of 111 samples. Although little information was available which would be of assistance in assessing fitness for human consumption based upon bacteriological examination, and there appeared to be only two isolated instances of food poisoning attributable to the consumption of cheese, nevertheless certain of the reports indicated contamination by staphylococcus Aureus, an organism which is often responsible for food poisoning and the Medical Officer considered that he was justified in taking action in the matter. The Authorities of the exporting country were informed that samples of cheese had given results upon bacteriological examination which were inconsistent with those to be expected from cheese deriving from pasteurised dairy products and that it appeared contamination was being introduced at some stage of processing. A letter was subsequently received from the Government Department concerned outlining the measures being adopted and the research work in progress in order thatthe source of contamination be traced and eliminated. It was evident that this Department was greatly disturbed by the facts disclosed by the survey of their produce in London. On 16th March, the Medical Officer met representatives of this exporting country when the whole position was discussed. During the ensuing weeks reports were received from two local authorities of outbreaks of food poisoning in hospitals which were subsequently established to be due to the consumption of cheese imported from the country in question. The number of persons affected in these two outbreaks was approximately 120. Preliminary enquiries suggested that a grade of cheese intended for manufacturing was responsible for the food poisoning outbreaks at the hospitals, and subsequent investigations confirmed this. As a result of these incidents the country concerned has required that in future all cheese be manufactured from pasteurised dairy products. DESICCATED COCONUT Since December 1959 all desiccated coconut imported from Ceylon has been detained pending bacteriological examination following the findings of fairly widespread Salmonella contamination. The following letter was received from the Ceylon Coconut Board in September 1961 and the picture now presented is vastly different from that originally presented by reports of the universally complete disregard of hygiene in the mills. "Applications from 80 Desiccated Coconut millers for the registration of their mills have been received by the Board and inspections of these mills are being made to ascertain whether they are providing themselves with the equipment and adopting the measures called for by the Board for the 1st stage of the implementation. These requirements are as follows (a) the provision of a sterilising device to sterilise the coconut during manufacture. (b) sectionalisation of the mill to prevent recontamination afterthe coconut is sterilised. (c) chlorination of water. (d) provision of mechanical packing equipment for packing in export containers at the mill. (e) medical examination of all workers employed in the post sterilisation processes to ensure that they are not carriers of pathogenic organisms. As soon as the Board is satisfied that a sufficient number of mills are suitably equipped, shippers will be notified that licences for the export of Desiccated Coconut will be given only for the produce of such mills. These mills will be given an identification mark (code No.) which will appear on all export packages containing their produce. It is not possible at present to say exactly when this measure will be introduced but we would state tentatively that it should not take more than 5 to 6 weeks. We are also going ahead with our arrangements to establish a Bacteriological Laboratory for the routine testing of the daily production of all registered mills. Orders have been placed for the necessary equipment and the Laboratory staff is being recruited. Additional staff to carry out the inspection of mills will be assuming duties at the end of this month. After a short training course in Colombo they will be posted to the areas where the mills are situated." 26 It is hoped that the measures of control instituted by the Ceylon Government will overcome their difficulties and result in their export of a clean and safe article of food in order that the restrictions at present applied may be relaxed. THE LEAD IN FOOD REGULATIONS, 1961 These Regulations will come into force on 16th April, 1962, and prescribe maximum limits of lead and lead compounds in various foods including non-alcoholic beverages; spirits and wines, concentrated fruit juices, raw and refined sugar, apples, pears, tomato juice, puree, paste or powder, canned fish and fish pastes, canned meat pastes, dried or dehydrated vegetables, cocoa powder, tea, flavourings, spices and colourings. It will be an offence to sell, consign, deliver or import any food containing lead in excess of the permitted amount. When any food is certified by a public analyst as being food offending againstthe Regulations it may be treated for the purposes of Section 9 of the Food and Drugs Act, 1955 as being unfit for human consumption and may be seized and destroyed on the order of a Justice. Since the examination of tea ceased to be carried out by H.M. Customs & Excise and was continued by the Corporation in January 1959, the lead content of certain teas, principally Formosan and Indonesian, has occasionally been found to exceed the limit of 10 parts per million recommended by the Food Standards Committee in 1954. At present there is no statutory limit for the lead content of tea, and teas showing lead in excess of the recommended limit of 10 p.p.m. have been released subject to blending with other lead-free teas in such proportion that the resultant blend contains lead well within the accepted limit. The imposition of a statutory limit for lead in tea is welcomed, as although importers have for the past three years been warned in regard to this contamination it is still found in teas from the sources mentioned. The penalty for an offence under these Regulations is a fine of up to one hundred pounds or three months imprisonment or both. IMPORTATION OF FROZEN PRAWNS A regular importation of the above mentioned commodity has been carried on during the past year. In the first instance bacteriological examination was revealing very high surface plate counts which suggested in the case of the cooked prawns, unhygienic handling during processing. In certain instances coagulase and positive staphylococci were isolated. These conditions gave cause for concern. With the close co-operation of the administrative staff and other interested local authorities, representations were made to the trade and to the responsible exporters in the country of origin. This same co-operation, which was greatly appreciated, has enabled the problems associated with the sampling and detention of this commodity and arising from its deep frozen condition, to be satisfactorily overcome. As a result of this persistent combined effort it is gratifying to be able to report the great improvement which has been effected with consignments latterly being found in an almost sterile condition. However a strict control will continue to be exercised in respect of this commodity. IMPORTED MEATS During this period 382 ships discharged meat in the Royal Docks. The work of your Inspectors during this period was directed towards the control of imported meat by detention and examination and embraced not only inspection of apparently unsound meat but also a continued effort to detect diseased meat and meats which might have been contaminated with food poisoning organisms. It will be seen that the yearhas been outstanding for the considerable quantities of meat examined for disease and the exceptional amount of time and energy spent on the problem of South American Horsemeat. 27 Further to this activity the implementation of the Food Hygiene (Docks Carriers) Regulations has imposed additional responsibility in that the requirements as interpreted by your Inspectors involves the departure from long established conditions and practices in the discharge of meat ships. Sustained pressure has been directed towards educating dock officials and personnel into new ways, at times a slow process, but bringing the first successes this year. The Meat (Staining and Sterilization) Regulations, 1960 came into operation in November 1960. Its greatest impact during the last year was undoubtedly felt by the pets food traders who were importing Argentine Horsemeat. It should be realised that this piece of legislation enables the local authority for the first time to have jurisdiction over meat notintended for human consumption. While this control was necessary and welcome it has brought with it the problems always associated with new regulations — ignorance of their implications by the trade and the need of new techniques to meet the changing circumstances on the part of the Inspectorate. In this respect the Port Health Inspectors and the horsemeat traders have had to arrive at an agreed basis for working which has been largely satisfactory after many protracted but necessary meetings and discussions. The following tables summarize the work of detention and examination carried out during the year. Meat Detained as Routine Inspection for Disease An effort is made to cover as wide a field of different meats as is necessary to obtain a broad picture of the soundness or otherwise of various meats and offals imported via the Port of London. Commodity Argentine U.S.A. New Zealand Australia Bechuanaland Brazil Chile Southern Rhodesia Uruguay Total Ox/Beef Livers Bags 5295 20 139 263 18 190 10 20 5955 Ctns. Beef Briskets 5 70 5 80 Beef Tongues 27 5 5 37 Beef Kidneys 20 5 25 Beef Skirts 2 2 Beef Hearts 2 5 7 Pig Livers 10 Kenya 2 12 Sheep Livers 2 2 Total 6120 Sheep Glanded 3100 300 942 4342 Beef Glanded e >0 Fores 110 >0 Hinds Cold Store It has been again apparent that only the most careful inspection in the country of origin will ensure that beef livers are free from hydated cysts. Time and energy devoted by the Cold Store Officer to this commodity alone is evidence that here is a problem still to be solved by inspecting authorities abroad. It may be opportune now that the Imported Food Regulations are being reviewed, to require that the substance of the liver be incised in every case as part of the routine inspection. During the year much less damaged meat has had to be dealt with possibly due to improved handling and a better standard of carriage of refrigerated meat. There has however been need for a very marked increase in bacteriological sampling, and the Cold Store Officer and the inspection room staff have been working to the capacity of the butcher's shop. 28 Bacteriological Sampling The table below shows the extent of work completed during the year. Boneless Beef and Horsemeat have been the two most urgent imports requiring close control and examination. At the commencement of the year boneless beef from Bechuanaland showed an incidence of contamination by Salmonella organisms which was consistantly too high. It is pleasing to report that the incidence decreased considerably as a direct result of pressure brought to bear at the Port and this import is now a reasonably satisfactory article of food. Bechuanaland Boneless Beef • Salmonella January 1961 163 Samples 16 positive January 1961 192 " all negative May 1961 45 " all negative June 1961 30 " 3 positive August 1961 10 " 1 positive August 1961 10 " all negative November 1961 10 " all negative Horsemeat As a result of routine bacteriological sampling, boneless horsemeat from the Argentine has been found to have a very high incidence of Salmonella contamination, the pattern being so consistent that it became necessary to detain all shipments on arrival for sampling at Colindale Laboratory. The bulk of this meat is destined for the pet trade and is sold raw in shops throughout the country. It was evident that there was a public health hazard in the distribution of this meat into shops and homes and from the animals themselves, and importers undertook under written guarantee that it would be sold to pet food shops only. Parcels considered to be unfit for human consumption were required to be sterilised before sale. The following figures show the extent of the problem and the quantities dealt with during the period under review. Twenty-seven vessels brought horsemeat from the Argentine and carried a total of 64,937 packages. A total of 1,372 samples were drawn and 620 samples were positive salmonellae. As an additional check samples were also drawn from New Zealand and Bulgarian horsemeat. The trade has decreased sharply as a result of the action of this Authority in detention and sterilisation df entire shipments. It is hoped that the killing establishments will be able to produce a satisfactory standard of meat and in the future resume normal trading. The following table shows the variety of meats examined bacteriologically during the year. Commodity No. of Samples Positive Salmonella Other Organisms Kangaroo Meat 5 4 Boneless Beef 534 22 Boneless Mutton 40 6 Boneless Veal 19 1 Horsemeat 1,372 620 Cooked Chicken Meat 5 – Aerobic Sporing bacilli, non-haemolytic streptococci, and coagulase positive staphylococci. Duck Meat 2 – Coagulase positive staphylococci. Lymph Nodes. Chilled Beef 24 Nil Nil Swabs. Chilled Beef 21 Nil Nil Total - 2,022 653 7 29 Food Hygiene Regulations The year has seen a marked improvement in the hygienic discharge and handling of meat from refrigerated vessels. After lengthy meetings and discussions we have at last seen the end of the use of straw in meat vehicles. Quays are properly hosed down before work commences and are kept clean during the time the ship is discharging. Equipment is well maintained and with few exceptions of a good standard. Head and shoulder coverings are now worn by all porters shouldering meat and research is going on to decide upon the best type of apron for wear at the meat table and for the men delivering meat into vehicles. A new type of foot covering for the hold worker has been designed and used experimentally and should soon be in general use. A comprehensive survey is now being undertaken of the many hundreds of vehicles regularly carrying meat in the docks. There is already a great improvement, but more needs to be done before they are all satisfactory. This will involve the owners in structural improvements and in a better organisation for routine cleansing. The efforts made during the year to ensure that the Food Hygiene Regulations were enforceable on board ship may yet bear fruit, but as things are at present it is an unsatisfactory state of affairs administratively. The increase in the number of samples drawn for bacteriological examination, although chiefly horsemeat, does highlight the difficulty experienced in finding laboratory facilities able to cope efficiently with a large number of samples. The goodwill and co-operation of the Public Health Laboratory at Colindale is a pleasant feature which is sometimes taken for granted. This laboratory was accepting samples to the limit of its capacity to deal with them, but was nevertheless far from keeping pace with the flood of work, nor could it be expected to. Consideration must also be given to the adequacy of the Inspection Room at No. 6 Cold Store. The position has been reached where any increase in either bacteriological examinations or inspections for disease can only take place to the detriment of existing routine work. It is hoped in the next few months to see the commencement of the work of installing washhand facilities and W.C. facilities at meat berths in the Royal Docks. Consultation has already taken place with the Port of London Authority and it is expected that they will put into effect the recommendations of your Officers very shortly. The ever increasing importance of Public Health Control of imported foods coupled with the high standard of hygiene required in a modern community has been reflected in the years work. As types of meats and methods of handling change, so must the methods of control keep pace and be kept under frequent review. FOOD HYGIENE (DOCK CARRIERS, ETC.) REGULATIONS, 1960 These Regulations came into force in November 1960. The impact of these regulations fell principally upon the meat industry who are by far the biggest handlers of unprotected foodstuffs. As the bulk of Imported Meat is discharged in the Royal Group of Docks, the implementation of these Regulations became a major consideration by your officers responsible for this control. The first issue was to define the legal requirements in terms of meat handling practice. A series of meetings took place with the many interests involved—Shipping Companies, Stevedoring Companies, Port of London Authority, Lighterage Companies, Road and Rail Hauliers and finally with the Dockers and Stevedores Unions. At these meetings, which took place over several months, the standards required by this Authority were explained and the best methods of complying with them were exhaustively considered. In all, eight major meetings took place, preceded and followed by many meetings at docks level. Broad agreement was reached on all important issues—some of which were put into effect immediately and others (such as those of a structural nature) needed further detailed consideration. The progress made during the period of the report may be summarised as follows:Quays Meat berths are hosed down prior to the discharge of a meat ship. As far as practicable no cargo liable to contaminate the meat is stowed on the quay. Generally it is possible to keep the quay entirely free of any other cargo. 30 The quay is kept clean during the discharge by sweeping and is again hosed down ready for the next vessel. A complete survey of all the 'meat berths' was carried out by your inspectors for the purpose of deciding what provisions could be made for W.Cs, urinals and wash-hand basins for the use of food handlers. Following a tour with the P.L.A. Officials the programme of work was agreed. It is expected that the work will be done in 1962. Vehicles The major road hauliers in the Port of London control some 1,351 units of insulated transport, together with the smaller operators and provincial concerns also using the docks, some 1,500 road vehicles came within the scope of the Regulations. In addition, insulated rail trucks and lift boxes are operated by British Railways, and the Port of London Authority use 80 rail wagons of their own for internal meat transport. The first problem was to prohibit the use of straw in road and rail vehicles the use of which masked the real condition of the vehicle. Some opposition was encountered from the trade as it was suggested that straw had its advantages as an insulating material and as a cushion against rubbing of exposed meat. To stress the undesirability of straw in proximity to unprotected foodstuffs, bacteriological samples were drawn. The results are summarised in Table 1. Straw was then prohibited. A preliminary survey of the road and rail vehicles revealed that the standards were varied, some vehicles being structurally unsuitable, others in excellent order, and a great many being between these two extremes. It became apparent that a detailed report would need to be prepared and a programme of reconstruction agreed with the various companies, this would take time, but immediate action was taken to turn away all dirty or structurally unsound vehicles at the meat berths, and this resulted in a steady improvement over the latter part of the year. The detailed survey has commenced and a full report covering every aspect of the problem will be submitted. The Port of London Authority's rail trucks have been the subject of discussions with them and the present policy is to purchase more modern second hand trucks from British Railways and to metal line the better of the existing stock. Equipment A reasonably high standard of equipment is now in use for the handling of meat cargoes. Although a standard type of equipment is not used by the stevedoring companies it has been possible to adapt and improve where necessary to produce hygienic meat nets, tables, bogies hand trucks, working boards, etc. A regular cleansing programme has now been instituted. Personnel Following the discussions with the Port Employers and the Union representatives of the employees, experiments have taken place with different types of protective clothing. The hold worker, the quay worker and the man portering chilled beef each handle meat in a different manner and consequently require different protective clothing. Those responsible for stevedoring operations wish to place bulk orders for this clothing and are anxious to be sure that shoulder coverings, head coverings, aprons and foot coverings are all practicable and acceptable to those who will wear them. It is proposed therefore that early in 1962 a pilot scheme will be run using 1,000 canvas boots and 600 plastic aprons. Linen shoulder and head coverings are already standard practice for the chilled meat porter. Conclusion The policy of prior consultation and mutual agreement of codes of practice has been gladly accepted by the shipping and allied industries engaged in handling imported meats and it is the hope of your officers that the final result will be a credit to the Port. 31 TABLE 1 Results of Bacteriological Examination of Straw Samples Date Sampled Lab. No. & Sample No. Description of Sample Surface plate Count per gm. at 37 °C Coliform bacilli Mould Count per gm. at 22°C Predominant Organisms 6.4.61 F 2337 1 Straw from Road Vehicles, No. 29 Shed, Royal Albert Dock. 8,500,000 Not found in 0.1 gm. 2,500,000 Organisms of the chromobacterium group, diptheroid and moulds. " F 2338 2 Straw Store "A" Berth, Royal Victoria Dock. 400,000 Present in 0.1 gm. (non-faecal) 50,000 Aerobic sporing bacilli, organisms of the chromobacterium group and moulds. " F 2339 3 " 1,500,000 " 50,000 " " F 2340 4 Railway Store "Z" Shed, Royal Victoria Dock. 550,000,000 Present in 0.1 gm. (Faecal) 2,500,000 Aerobic sporing and coliform bacilli, micrococci and organisms of chromobacterium and 2 chromobactium groups. " F 2341 5 " 9,500,000 " 500,000 Aerobic sporing and coliform bacilli yeasts, moulds and organisms of the chromobarium proup. " F 2342 6 Bank at rear of "F" Shed, Royal Victoria Dock. 150,000,000 Present in 0.1 gm. (non-faecal) 500,000 Aerobic sporing and coliform bacilli, Proteus and organisms of the chromobacterium group. 13.4.61 F 2561 1 No. 29 Shed, Royal Albert Dock. 3,000,000 " 50,000 Aerobic sporing and coliform bacilli micrococci organisms of the chromobacterium group. " F 2562 2 No. 5 Shed, King George V Dock. 70,000,000 " 250,000 " " F 2584 3 " 150,000 Not found in 0.1 gm. 750 Aerobic sporing bacilli and micrococci. " F 2563 4 Van No. 2986. 5,500,000 Present in 0.1 gm. (non-faecal) 50,000 Aerobic sporing bacilli micrococci and organisms of the chromobacterium group. " F 2564 5 " 5,500,000 Not found in 0.1 gm. 500,000 Aerobic sporing bacilli, micrococci and organisms of the chromobacterium group. " F 2565 6 B.R. Container, No. FM 14427 B. 17,500,000 " 75,000 " 9.5.61 F 3120 1 B.R. Container, No. FM 60514 B. 600,000 " 50,000 Moderate growth of micrococci organisms of the chromo-bacterium group, yeasts and moulds. " F 3121 2 B.R. Container, No. FM 59858 B. 900,000 " 3,500 Organisms of the chromobacterium group and micrococci. " F 3122 3 Daws Bros. (Haulage) Ltd. Insulated trailer No. 30. 1,000,000 Present in 0.1 gm. (non-faecal) 250,000 " " 3123 4 B.R. Container, No. FM 59896 B. 500,000 Not found in 0.1 gm. 5,000,000 " " F 3124 5 B.R.S. Container, No.TX493. 200,000 " 50,000 " " F 3125 6 B.R.S. Container, No. TX 440. 2,000,000 " 500,000 Micrococci, moulds and organisms of the chromobacterium group. 32 THE FOOD HYGIENE (GENERAL) REGULATIONS. 1960 This legislation embraces pleasure craft with food and drink catering arrangements and includes many of the familiar passenger launches plying between the main piers, as well as the three larger passenger ships that make daily excursions to coastal resorts and the Continent. The range of catering varies according to the duration of the trip, from soft drinks and biscuits to full scale meals and beverages. An assessment of the fleets has been made during the active Summer months preparatory to a detailed survey to be carried out when the vessels are returned to maintenance yards between seasons. As expected, most maintenance is carried out in boatyards outside the district of the Port Health Authority; thus arises possible embarrassment when two local authorities have powers to exercise the Regulations in regard to the same property, diplomacy invariably providing a solution. The co-operation of the Ministry of Transport and the Owners has been secured to cope with any major structural alterations affecting the safety of the vessels. Of the 50 launches in regular summer service, only 40 provide a catering service of some kind. The detailed surveys of these craft indicate that none complies fully with the requirements, with deficiencies varying in magnitude and type. It is evident at this stage that attainment of the required standards of hygiene will necessitate acceptance of improvements by reasonable stages. One difficulty common to all craft is the restricted storage capacity for wholesome fresh water. It is an advantage that much of the food supplied is pre-packed and ready for sale, particularly aboard the smaller craft. The three large vessels engaged on excursions to coastal resorts and the Continent pose a much greater problem when catering for as many as 2,300 passengers. None are of recent design or construction and the scope for structural modifications is very restricted, as also are increased fresh water storage capacity and available electric power. It is possible that applications will be made for temporary exemptions to be granted in respect of these three vessels as provided for in the Regulations in cases where full compliance cannot reasonably be secured. Some months must elapse after this initial survey during which time the necessary improvements will be effected. Thereafter routine inspection of all the vessels will be put into operation. It is imperative that close liaison be maintained between those Authorities charged with the application of these Regulations if uniformity of standard is to be achieved. THE DOCK STRIKE Imported Foodstuffs The effect of the dock strike in the Port of London in May was minimised by the non-participation of the dock labour at Tilbury, Surrey Commercial and Regent's Canal Docks. The delivery of all perishable foodstuffs from the London and Royal Group of Docks was effected before deterioration had reached the stage to warrant condemnation. The West India Dock bore the brunt of the stoppage and as a direct result it was necessary to condemn and destroy 21 tons 8 cwts of foodstuffs as follows :- carrots 9 tons 5 cwts. 431 bags onions 10 " 15 " tomatoes 12 " french beans 1 " 30 bags potatoes 15 " 21 tons 8 cwts. CLEAN AIR ACT, 1956 THE DARK SMOKE (PERMITTED PERIODS) (VESSELS) REGULATIONS, 1958 So far as installations in the Port of London are concerned, several new furnaces and modifications have been notified and surveyed. All complied with the provisions of the Act and fuel oil or smokeless fuel was adopted in each case. Observance of the basic principle of prompt suppression of offensive emissions by every means possible, rather than to have recourse only to legal proceedings, remains unaltered and this policy has contributed substantially towards the existing goodwill of the international shipping industry. 33 Statutory action has been taken as indicated 1961 1960 No. of Vessels infringing Regs. 19 36 No. of Notices Served 12 Black 18 15 Black 3 Dark No. of Prosecutions 3 Black 6 5 Black 1 Dark On the technical aspect, the trend to abolish hand-fired coal burning furnaces in favour of the oil-fired installation and diesel engine has continued, thereby helping considerably to rid the Port of visible atmospheric pollution. In confirmation of this trend, figures in respect of regular collier fleets and harbour craft are quoted. The increased industrial demands for fuel oil, including the large power stations, has reduced the coal traffic from the North-east seaports, consequently the collier fleets have been reviewed by the Owners. It has been gratifying to witness the wisdom and co-operation in the course of this re-organisation which was carried out with the provisions of the Act in view. River traffic is usually the most sensitive to smoke control because of fluctuating power demands. In his successive Reports for the Upper and Middle River districts, Senior Inspector Marshall has submitted a picture of continuous and steady progress with a background of tactful pressure and full technical co-operation with all concerned. The overall improvements in the Port have given a measure of satisfaction to the Inspectors, who are now seeing the results of their earlier efforts and the time devoted to securing goodwill in the observance of the requirements of this legislation. Experience indicates that vigilance and prompt intervention must be continued in order to cope with the changing personnel of international shipping and the occasional defection of the human factor. COASTAL COLLIERS - FLEET SUMMARY 1959 Fleet No. Diesel Steamships Coal Fired Oil Fired A. C.E.G.B. 38 7 27 4 B. N.T.G.B. 21 7 9 5 C. S.E.G.B. 17 8 9 0 D. S. CLARKE 29 16 10 3 E. CORY 26 6 19 1 F. F. FENWICK 22 2 11 9 G. COMBEN LONG STAFF 13 6 3 4 H. QUEEN SHIP 11 3 8 0 I. HUDSON 9 2 6 1 Totals 186 57 *102 27 Of Total — 186 Vessels 69.4% Steamships 30.6% Motor ships Of Steamships — 129 Vessels 79.1% Coal hand fired 20.9% Oil fired *Includes 5 natural draught. Number of colliers proceeding above Tower Bridge — 47 27 Steamships 20 Motorships 34 COASTAL COLLIERS - FLEET SUMMARY 1961 Fleet No. Diesel Steamships Coal Fired Oil Fired A. C.E.G.B. 28 7 16 5 B. N.T.G.B. 19 7 7 5 C. S.E.G.B. 14 11 3 0 D. S. CLARKE 36 26 6 4 E. CORY 25 6 15 4 F. F. FEN WICK 14 4 3 7 G. COMB EN LONG STAFF 15 9 1 5 H. QUEENSHIP 5 3 2 0 I. HUDSON 9 2 5 2 Totals 165 75 58 32 Of Total — 165 Vessels 54.5% Steamships 45.5% Motorships Of Steamships — 90 Vessels 64.4% Coal hand fired 35.6% Oil fired No natural draught coal burning steamships remain. Number of colliers proceeding above Tower Bridge — 36 23 Steamshhips 13 Motorships HARBOUR CRAFT - SUMMARY 1959 Type No. Diesel Coal Fired Oil Fired Dredgers 11 1 9 1 Hoppers 16 1 14 1 Wreck Lighters 8 1 7 0 Grain Elevators 8 7 1 0 Heavy Lift Cranes 6 0 4 2 Auxiliary 2 0 2 0 Totals 51 10 37 4 HARBOUR CRAFT - SUMMARY 1961 Type No. Diesel Coal Fired Oil Fired Dredgers 10 1 2 7 Hoppers 11 2 6 3 Wreck Lighters 8 1 7 0 Grain Elevators 9 8 0 1 Heavy Lift Cranes 6 0 2 4 Auxiliary 3 1 2 0 Totals 47 13 19 15 35 "SHIP" TUG FLEETS - SUMMARY 1959 Fleet No. Diesel Steam Coal Fired Oil Fired SHIP TOWAGE 17 0 14 3 ALEXANDER 18 3 6 9 P.L.A. 19 8 7 4 Totals 54 11 27 16 "SHIP" TUG FLEETS - SUMMARY 1961 Fleet No. Diesel Steam Coal Fired Oil Fired SHIP TOWAGE 21 4 13 4 ALEXANDER 18 6 2 10 P.L.A. 17 10 3 4 Totals 56 20 18 18 LOADING AND TRANSPORT OF REFUSE BY LIGHTERS BYE-LAWS FOR THE PREVENTION OF NUISANCE ARISING FROM REFUSE IN OR UPON ANY SHIP, BOAT OR VESSEL The Port of London Health Authority's bye-laws are designed to control — (a) The prevention of nuisances arising from dust, ashes, rubbish, carrion, fish or filth or other matter or thing in or upon any ship, boat or vessel within the district of the Port Health Authority and (b) the removal of offensive matter or liquid. There are twenty one refuse wharves situated within the River districts, eighteen of these are in regular use or capable of being used if required for the loading of refuse lighters. The refuse is discharged at the three land reclamation centres of Hornchurch, Rainham & Pitsea. The importance of this branch of London's refuse disposal service will be appreciated when it is realised that this year nearly three quarters of a million tons of refuse was disposed of through the wharves. The enforcement of the Bye-laws is carried out by the Port Health Inspectors stationed on the River districts where, in addition to regular observations of the refuse wharves and lighters being made from the Port Health Cutters, shore inspections are made at short intervals thus keeping contact with all the personnel engaged in loading the lighters and with the problems they meet. The Inspectors report that apart from broken sheet lashings and displaced or torn tarpaulinsworking mishaps caused by wind and weather —no serious infringements of the Bye-laws by the loaded lighters on passage down river to the discharging wharves had been met with during the year. The wharves, however, still leave much to be desired, the Authority still being far from satisfied with the arrangements in operation at some of the wharves where the loading facilities are antiquated and insanitary and because of their location and structure are, without extensive reconstruction and modernisation,unable to be improved. Finance of course plays a large part in often delaying necessary modifications and modernisation. Progress has been made at some of the wharves. There has been a definite trend away from the direct tipping of refuse from road vehicles into the lighters towards the indirect method whereby the refuse is first tipped into a collection pit or walled area and then loaded into the lighters by grabs, thus the refuse lorries are not delayed and the lighters can be loaded at any state of the tide without creation of air borne dust and spillage overside. 36 Owing to the increase in bulk of domestic refuse it has been found that by using the weight of the grab to compress the refuse the loaded tonnage of the lighters can be increased by up to twenty per cent. The Royal Commission report for the re-organisation of local government in Greater London published in November 1961 recommends that the proposed Council for Greater London should be the authority for refuse disposal and that an intelligence department should be formed for continuous research into the refuse problems of Greater London as a whole. It would be desirable for the Port Health Authority's views on refuse disposal by river to be made known. However, there still remains the major problem of tipping into lighters from open wharves and it would appear that, in spite of modifications to operational equipment, there is no completely satisfactory solution while the procedure is carried out by an indifferent labour force and the refuse is exposed to the natural elements. HOUSEBOATS AT BENFLEET The Essex County Council Act, 1952, provides that the mooring of any houseboat within the County shall not be lawful without the consent of the Council of the district in which the houseboat is situated, and that the Council may require the owner or occupier to remove or demolish any houseboat not authorised by them. The Port and City of London Health Committee are, however, still responsible under the Public Health (London) Act, 1936, for the sanitary supervision of houseboats coming within the jurisdiction of the Port Health Authority, although under the Essex County Council Act, 1952, the local Council in Essex are now responsible for the licensing and drawing up of conditions under which they are prepared to grant licences to houseboats. The duties of the Committee in regard to the sanitary supervision of houseboats are safeguarded by Section 212 of the Essex County Council Act, 1952, which provides inter alia that no consent shall be given to the mooring of any houseboat within the Port of London without the previous written consent of the Corporation of London as the Port Health Authority of the Port of London. During the year the Benfleet Urban District Council granted temporary consents, subject to the approval of the Port Health Authority, to twenty-two houseboats. No objection to these consents was raised by the Port and City of London Health Committee. PUBLIC HEALTH 4CT 1936, PART X - CANAL BOATS The Public Health Act 1936 provided, inter alia, that a Port Health Authority (being a registration authority) make an annual return within 21 days to the Minister of Health of any defects and infringements disclosed by the Port Health Inspector in his reports. That requirement has, as from 1962, been abrogated by the Public Health Act 1961 (Sect. 79), which received the Royal Assent on 3rd August. One hundred and sixty inspections of canal boats were made during the year. Thirty-three canal boats were found to have a total of fifty-four defects, as follows:- Cabin in need of cleaning and/or painting 24 Defective condition of cabin top and/or sides 17 Defective condition of cabin hatch doors 1 Defective flooring 5 Defective bulkheads 1 Defective cupboards 1 Inadequate ventilation 1 Defective insulation resulting in dampness 2 Defective and dangerous structure 2 Total 54 The Owners and Master of the defective craft were in each case notified and required to carry out the necessary repairs. 37 The following infringements of the Act were also found:- Certificate of Registration not produced 8 Certificate of Registration requiring renewal 4 Registration Marks on boat obliterated or illegible 2 Registration Mark on boat incorrect 1 Overcrowded accommodation 3 Total 18 The Owners and Masters were informed of the requirements of the Act in these respects. Among the infringements of the Act detailed above is that of "overcrowded accommodation", which is not normally a recurrent one and is, therefore, of special interest. The three instances referred to in this category were the subject of reports by the Port Health Inspector at Regents Canal Dock, and concerned the habitable conditions existing aboard certain of the British Transport Waterways canal boats. Although superficially unconnected the incidents were related in that they concerned one family, a rather large one comprising six children all of or under school age besides the Master —or Steerer as the person in charge is colloquially known—and his wife. This was two in excess of the permitted complement, the accommodation which the family occupied consisting of the living-quarters provided by two canal boats which are normally coupled together. The problem of relieving the overcrowding proved more formidable than at first anticipated, because none of the children was old enough to work a third boat, nor would the Steerer consent, at first, to any disintegration of his family by allowing any of its members to be accommodated at the hostel at Birmingham. The Fleet Superintendent of British Transport Waterways was very co-operative when the matter was brought to his attention, and approached it from every possible angle in an endeavour to find a solution but with no immediate success. It must be borne in mind that the provision of adequate living accommodation on canal boats, because of restrictions on their size which is of necessity measured by their ability to negotiate the locks and tunnels on a canal, is a problem hardly comparable with that generally encountered by housing authorities; the latter are able, in the majority of cases, to alleviate such conditions by the allocation of a larger dwelling. The one great difficulty confronting canal boat owners is that the habitable accommodation cannot easily be altered to meet the needs of large families without some encroachment on the space needed for cargo, and the standard dimensions regulating the size of these boats do not, therefore, permit any extensive alteration. The Superintendent promised to pursue the matter further, and subsequently put forwarded alternative suggestions whereby the problem might be resolved:- (1) To allocate to this family one of the newly designed "butties" which were in the course of being constructed. This, however, did not materialise. (A "butty" boat is a craft which, being without mechanical means of propulsion, must be towed.) (2) To send some of the Steerer's children to a new hostel at Bulls Bridge, Middlesex, which was due for completion in the near future, a course to which he had readily agreed. At this point the matter for a time remained in abeyance. Then, suddenly, it was again brought prominently to attention by the Steerer's wife, who, taking the matter into her own hands, gave it the necessary impetus which brought the whole business to a rather premature conclusion. She presented her husband with a daughter, which event was duly included in the report of the Port Health Inspector, who had occasion shortly afterwards to inspect the boat. His record enumerating the occupants included the laconic entry, "Daughter, aged two weeks." Aggravation of the overcrowded conditions on the two boats concerned could not then be overlooked, and it undoubtedly created a potential health risk for the newcomer which could not be permitted. The reaction of the Deputy Medical Officer of Health was definite and immediate, and an approach made to the British Transport Waterways received prompt attention. He was subsequently informed by the Waterways Authority that the Matron at the Birmingham Hostel, in view of the urgency of the matter, had given it prior consideration and had accepted two of the younger children into her charge. There the matter concluded, an episode truly reminiscent of A.P. Herbert. During the year fifteen certificates authorising the purchase of scheduled Dangerous Drugs were issued under the Dangerous Drugs Regulations, 1953, Regulation 13 (2) of which is as follows :- DANGEROUS DRUGS 38 (a) The master of a foreign ship which is in a port in Great Britain shall be authorised to procure such quantity of drugs and preparations as may be certified by the medical officer of health of the port health authority within whose jurisdiction the ship is or, in his absence, by the assistant medical officer of health, to be necessary for the equipment to the ship "until it reaches its home port. (b) A person who supplies a drug or preparation in accordance with a certificate given under this paragraph shall retain the certificate and mark it with the date on which the drug or preparation was supplied and keep it on his premises so as to be at all times available for inspection. FERTILISERS AND FEEDING STUFFS ACT. 1926 FERTILISERS AND FEEDING STUFFS REGULATIONS, 1955 Fourteen samples of Feeding Stuffs were submitted to the Agricultural Analyst. In each case the sample was found to be within the limits of variation permissible under the Regulations. OIL TANKERS Oil tankers do not usually require the attention of the Boarding Medical Officer but when such occasions do arise it is expedient to have the services available of a local medical practitioner rather than to send a Medical Officer all the way from Gravesend. For this purpose Dr. A.J. Fairrie, who is in partnership with Dr. K.C. Morris at Stanford-le-Hope, Essex, conveniently close to the Thames Haven area, was appointed as occasional Boarding Medical Officer. I am indebted to Dr. Fairrie for the following report:- Shipping The following figures show the numbers of sea going vessels berthing at the oil installations in this area in 1961. THAMES HAVEN: Ocean Going Tankers 704 Coasters 1,412 SHELL HAVEN: Ocean Going Tankers 209 Coasters 294 CORYTON: Ocean Going Tankers 144 Coasters 672 TOTALS: Ocean Going Tankers 1,057 Coasters 2,378 Communicable Diseases One ship was visited on behalf of the Port Health Authority, having on board a recovering case of Amoebic Dysentery diagnosed and treated in South America. Several cases were seen for the Shipping Companies concerned necessitating hospital investigation, one being another case of amoebiasis having recently had a liver abscess. Venereal Disease Nine cases were referred to Tilbury Hospital for diagnosis and surveillance. There was one confirmed case of Gonorrhoea, one of Chancroid and one of non specific urethritis. Rats Pest Control Operators visited Thames Haven at intervals. No figures for Rats destroyed are available but the numbers are thought to be less than last year. Mosquitoes No trouble was experienced this year. All fleets which were previous breeding grounds have been filled in at Thames Haven. Preventive Medipine A small number of Cholera, T.A.B. and Smallpox vaccinations were carried out for the Shipping Companies concerned. Deaths Two deaths occurred on board ships while in Port. One a case of suicide by shooting, another of Coronary Thrombosis. 39 VISITORS AND STUDENTS Although fewer overseas visitors have received instruction during this year, the number of overseas territories represented, includes African territories, Argentina, Burma, Bahrein, British Guiana, Ceylon, Cyprus, Hong Kong, Holland, India, Jordan, Mauritius, Malaya, Singapore, Turkey and Venezuela. In addition to this list are the many British visitors and students from the Government Departments, Local Authorities and centres of learning who are particularly interested in port health activities. This increased pressure on the busy role of the Inspectorate is always cheerfully borne, not only because of the interchange of personal ideas but a sense of duty to give of our experience and knowledge to diligent students. On the international aspect of port health work, these contacts become increasingly important and the status of this Port respected accordingly. One is left to believe that such contact will be all the more necessary should Britain enter the Common Market. Not least as a compensation for the instruction given is the frequent correspondence telling of promotions that are attributed to the knowledge gained in the Port of London. For thirty years, the Boarding Medical Officers have used m.v. "HOWARD DEIGHTON" which has reached the sunset of a gallant career. Although retaining a well preserved hull, the propelling machinery has become obsolete and the overall working performance now lags behind the standard expected in present major seaport activities — particularly for the Port of London. The Port installations are more widely spread over the shores of the Estuary, anchorages are available to the seaward limits and the Boarding Medical Officer is liable to be summoned there at any time and in any state of weather to cope with emergencies. The ability to execute any assignment in the shortest reasonable time with all amenities readily available for the task have been carefully considered in the design of the new vessel. Provision has been made to render the vessel self sufficient to meet any extended commitments in such major operations as controlling special quarantine incidents. Generally, the appearance and overall design is modern and to the particular requirements of the Port Health Authority. Nothing has been sacrificed that could normally contribute to the working efficiency and service appearance of such type of vessel, with due consideration of initial cost and running maintenance. Every effort has been made to provide ample space and comfort in the Hospital, Consulting Room, Officers' and Crew accommodation with associated sanitary conveniences. The Engine Room, Store Rooms and Workshops will be relatively spacious as, also, will be the Wheelhouse which is to be fitted with all necessary equipment for remote control of the engine and R/T sets for harbour service communications as well as direct contact with incoming shipping. LAUNCHES m.v. "HUMPHREY MORRIS" The new cutter for Gravesend Boarding Station The principal features of construction include a steel hull and main deck, but the entire superstructure will be built of a lightweight alloy. Other features include :- Length O.A. 97.5 ft. " W.L. 87.0 ft. Breadth Moulded 21.0 ft. Depth " 10.5 ft. Draft Forward 5.5 ft. Draft Aft. 8.0 ft. Displacement 160 tons Block Coeff 0.518 Gross Tonnage 130 Main Engine Diesel-of 655 S.H.P. Reverse-Reduction Gear 1.5 to 1 Electric Installation 64 k.w. at 230 A.C. Operational Speed 12 knots 40 THE LAUNCHING CEREMONY 15th July 1961 When the official party travelled by rail from London to Faversham, the weather conditions were wet and gloomy. Perhaps this symbolised a mourning sentiment for the physical absence of the late Chairman—Mr. Deputy Humphrey Morris — from the official party, because this eventful occasion was surely his in a personal sense. Motor coach transport was arranged from Faversham railway station to the spacious marquee erected in The Shipyard and close by the launching platform. The marquee was adequately furnished, lighted and warmed and ample provision made for refreshments to be followed by a buffet luncheon with service. An attractive feature of the lighting installation was the adaption of one of the actual illuminated signs to be fitted in the cutter and this very effectively served as a back-panel for the sideboard table. The entire setting and proceedings contrasted sharply with the comparatively miserable weather conditions outside where the "HUMPHREY MORRIS" rested proudly and comfortably alone on the launching cradle. As time sped on towards the appointed hour for the launching ceremony, hopes transcended fears and, as if by supernatural intervention, the rainstorm ceased, the clouds parted and allowed the sun to smile upon the site — precisely one half hour before the actual ceremony started. Advantage was taken of this interval by most of those attending to view the form of the hull, the main and auxiliary machinery and other equipment which had been set for the purpose at appropriate places nearby the marquee. Thereafter, the sun continued to shine and the "HUMPHREY MORRIS" waited, emaculate with new paint and dressed overall with bunting, expectantly poised alongside the decorated launching platform. At 1450 hours, the platform was occupied by :- The Vicar of Faversham Mr. and Mrs. Stanley Cohen Mr. Deputy Allcard Mr. and Mrs. Pollock Directors Mrs. McLennan and more than one hundred guests and spectators were assembled on both sides of the narrow river. The Vicar, dressed in his clerical robe, read passages from the Bible and addressed the assembly with special reference to the work of the new vessel. He laid stress on her missions of goodwill, hope and healing mercy to all crews and passengers regardless of race, colour or creed. Suitable prayers were offered to Almighty God for the success of her engagements in this humane and noble work, then all joined in offering the Lord's Prayer. The setting of the launching party on the white platform, particularly the ladies, provided a scene of modest splendour. Prayers ended, the first launching triggers, then the climax was reached when Mrs. Cohen officially named the ship "HUMPHREY MORRIS" in the traditional style with a bottle of champagne and invoked God's blessing on the ship and the crews that would sail in her. Incidentally, the bottle struck the bow of the ship with such a powerful impact that it was completely shattered and only the cork on the ribbon could be retrieved afterwards — although some of the guests caught the champagne spray — 'every action has a consequential reaction'. The last triggers were released and the ship slipped gracefully into the water—a perfect broadside launching. With a minimum of fuss the ship was soon moored alongside and made available for inspection. Particulars of her displacement and trim were checked and recorded to entire satisfaction. And so ended a truly happy and memorable day — an event which not only upheld the solemnity, dignity and prestige for such an occasion, but laid the foundation of a worthy memorial to the late chairman — Humphrey Morris — absent in the body but not so in spirit. 42 Cutter "HUMPHREY MORRIS" Launching Ceremony The above photograph shows (leading from left to right) — (1) Rev. F.W. Phillips — Vicar of Faversham (2) Miss Solveig Nicolaisen (3) Mr. M.B. Pollock (4) Mrs. Stanley E. Cohen (5) Mr. Stanley E. Cohen, Chairman, Port and City of London Health Committee (6) Mrs. M.B. Pollock (7) Mrs. A.C. McLennan (8) Mrs. E. McLennan (9) Mr. Deputy V. Allcard Launching of Cutter "HUMPHREY MORRIS" LECTURES, PAPERS AND ARTICLES Lectures and talks on the work of the Port Health Authority and allied subjects were given by Dr. Greenwood Wilson to various organisations including:— The Royal Institute of Public Health The London School of Hygiene and Tropical Medicine St. Bartholomew's Hospital Medical College The Cardiff Medical Society. Dr. Greenwood Wilson, at a meeting of the Royal Society of Health on 11 th October, 1961, presented a paper on "Imported Foods and the Nation" which is reproduced as an appendix to this Report. Dr. H. Amphlett Williams, Ph.D., F.R.I.C., Public Analyst, wrote an article on tea "Where does leaf assimilate the deadly cumulative poison of lead" which is also reproduced as an appendix to this Report. STAFF Mr. W.L. McLorg—General Administrative Officer It is with deep regret that I have to record the death in October of Mr. W.L. McLorg, the General Administrative Officer. Mr. McLorg entered the service of the Medical Officer of Health's Department as a lad in February, 1927. His efficiency, readiness to help and cheerful disposition had endeared him not only to his colleagues but to various officers of the Port of London Authority, Ministry of Health and the many Shipping Companies with whom his duties brought him into contact. In August, 1960 whilst on holiday in Poland, Mr. McLorg had a coronary thrombosis and as a consequence was in hospital in that country for many months. He returned to duty in March, 1961. His health seemed steadily to improve and by the end of the summer he seemed to be his old cheery self. However, whilst out for a walk one Sunday afternoon, he had another attack, collapsed and died instantly. His premature death will long be a cause of sorrow to his colleagues. Mr. P.W. Coombe, F.A., P.H.I.—Senior Port Health Inspector Mr. Coombe retired on the 1st April, 1961 after thirty-seven years of loyal service with the Port Health Authority. His duties for many years, had been primarily connected with meat imported into the Royal Docks. His knowledge and experience were of inestimable value, not only to the Port Health Authority, but to the meat importation trade in general. Over the years many appreciations have been received from visitors and students of Mr. Coombe's lucid and instructive lectures on food inspection. Mr. Coombe leaves the service with his colleagues' wishes for a long and happy retirement. 43 appendix i MEDICAL INSPECTION—From 1st January to 31st December, 1961 GRAVESEND Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total No. of ships medically inspected 140 133 161 141 151 166 149 134 149 133 144 138 1,739 No. of passengers 518 321 818 2,058 1,227 3,788 4,022 3,254 2,177 1,063 385 796 20,427 No. of crew 487 620 749 1,088 745 418 660 552 779 498 703 796 8,095 No. of ships arriving from abroad 1,105 1,037 1,184 1,091 1,217 1,212 1,340 1,166 1,230 1,062 1,260 1,158 14,062 appendix ii INFECTIOUS DISEASES Disease 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 (a) Cases reported- Cholera (including suspected — — — — — - — — - - Plague do. - - - - - - - - - - Yellow Fever do. - - - - - - - - - 1 Typhus Fever do. - - - - - - - - - - Smallpox do. - 1 1 1 - - - - 1 2 Enteric Fever 8 8 6 8 5 3 7 5 1 - Scarlet Fever - 2 - 2 2 2 1 4 1 - Measles 56 97 31 64 67 91 71 63 109 35 German Measles 13 6 7 5 3 7 25 2 8 12 Diptheria 2 - - 1 - - 1 - 1 2 Erysipelas - 1 - - 1 - . — - - - Pulmonary Tuberculosis 67 46 43 35 32 39 45 42 39 26 Other diseases (including chickenpox) 128 184 347 368 212 1,328 659 313 956 303 Totals 274 345 435 484. 322 1,470 809 429 1,116 381 (b) Admitted to Hospital- Cholera (including suspected) — — — — — — - — - - Plague do. - - - - - - - - - - Yellow Fever do. - - - - - - - - - - Typhus Fever do. - - - - - - - - - - Smallpox do. - - 2 - - - - - - - Scarlet Fever - - - - - 2 - - - - Diptheria - - - - - 1 - 1 - Enteric Fever 1 1 - 3 - 2 3 3 3 - Measles 3 16 21 12 20 35 5 8 10 11 Mumps 4 2 1 10 5 3 7 - 9 3 Dysentery 1 - 6 6 - 1 4 7 1 1 Other diseases (including chickenpox) 35 48 32 53 63 271 114 75 86 65 Totals 44 67 62 84 88 314 134 93 110 80 appendix iii RETURN OF RATS CAUGHT AND DESTROYED DURING THE YEAR 1961 Jan. Feb. Mar. April May June July Aug. Sept. Oct. Nov. Dec. Total London Dock— Warehouses 46 32 39 13 6 25 33 20 66 67 13 50 410 Vessels - - - - - - 7 - - - - - 7 St. Katharine Dock— Warehouses - - - - - - - - 1 - - - 1 Vessels — — — — — — — — — — — — — Surrey Commercial Dock— Warehouses - - 3 2 27 21 7 7 15 4 2 - 88 Vessels 46 46 — — — — — 2 3 24 - — 121 Regent's Canal Dock— Warehouses — — 1 - — — 2 8 — 2 — — 13 Vessels - - - - - - - - - - - - - East India Dock— Warehouses — — 1 - — — — 3 3 — — 6 13 Vessels — — — — — — — — — - - — — West India Dock — Warehouses 18 24 26 23 27 43 21 20 45 19 34 20 320 Vessels - 4 41 37 1 — 7 2 — 6 — — 98 Millwall Dock— Warehouses 40 17 17 10 29 7 67 5 17 18 3 — 230 Vessels 1 - - - - - - 8 - 1 — - 10 Royal Victoria Dock— Warehouses 65 3 23 12 25 49 38 50 33 47 41 41 427 Vessels 38 - 13 1 20 3 44 - 6 - 23 24 172 Royal Albert Dock— Warehouses 13 6 17 14 17 43 21 28 17 9 22 6 213 Vessels 57 1 41 31 21 21 21 84 9 28 9 18 341 King George V. Dock— Warehouses 3 — 11 2 6 18 2 8 7 - — — 57 Vessels — 4 - 7 7 14 5 — 3 — — — 40 Tilbury Dock— Warehouses 9 4 15 3 10 20 8 4 32 14 4 18 141 Vessels 72 26 194 132 56 15 82 94 223 99 121 1 1,115 River— Vessels 26 126 302 101 77 59 30 57 70 13 38 20 919 TOTALS 434 293 744 388 329 338 395 400 550 351 310 204. 4,736 APPENDIX IV General Summary and Analysis of the Sanitary Inspections etc. in the Port of London for the year ended 31st December, 1961 Type of Vessels/Premises Inspected Defective To be cleaned Foreign Going: Steam 11,969 186 386 Sail Nil Nil Nil Coastwise: Steam 1,376 31 3 Sail Nil Nil Nil Sub-Total 13,345 217 389 Inland Navigation: Steam 124 Nil 2 Sail Nil Nil Nil Lighters 573 7 25 Canal Boats: 160 72 7 Shore Premises: 10,923 245 209 Sub-Total 11,780 324 243 TOTAL 25,125 541 632 Areas where Foreign Going and Coastwise vessels were inspected Dock and River No. o f Inspections London & St. Katherine 1,206 Regents Canal 479 Surrey Commercial 1,462 East India 266 West India 1,222 Millwall 661 No. of vessels inspected in launches Royal Albert 1,237 Royal Victoria 845 "Alfred Roach" King George V 761 667 "Howard Deighton" U pper River 667 Middle River 965 "Frederick Whittingham" Lower River 791 1,756 "Alfred Robertson" River Medway 1,106 Tilbury 1,677 10,922 Inspected in Docks etc. TOTAL 13,345 13,345 Nationalities of Foreign Going and Coastwise Vessels inspected No. o f inspections No. of inspections American (U.S.A.) 134 brought forward 11,077 Argentinian 36 Italian 56 Belgian 107 Japanese 80 Brazilian 23 Lebonese 14 British 7,508 Liberian 102 Bulgarian 6 Monrovian 15 Costa Rican 4 Nigerian 14 Danish 188 Pakistani 5 Dutch 1,390 Panamanian 67 Finnish 227 Polish 67 French 82 Portuguese 2 German 1,072 Russian 147 Ghanian 29 South African 11 Greek 141 Spanish 163 Icelandic 6 Swiss 6 Indian 83 Norwegian & Swedish 1,377 Iranian 10 Turkish 48 Israeli 31 Yugoslavian 94 Carried forward 11,077 TOTAL 13,345 During 1961 Port Health Inspectors referred 79 sick seamen to hospital. appendix v DOCKS WITHIN THE JURISDICTION OF THE PORT HEALTH AUTHORITY Dock Group Docks Water Area Acres Lineal Quayage Miles I London 34 3 St.Katharine 10 1 Regent's Canal 11 ½ II Surrey Commercial 135 8 III West India 97 4 East India 23 1 Millwall 35 2 IV Royal Victoria 85 4 Royal Albert 84 3 King George V 64 3 V Tilbury 106 4 The River distance between the Western and Eastern limits of the Port is about 68% miles. powers The principal Acts of Parliament and Statutory Instruments affecting the work of the Port Health Authority of the Port of London are ABATEMENT OF NUISANCES AND REMOVAL OF REFUSE Public Health (London) Act, 1936 ADMINISTRATION Public Health (London) Act, 1936 Order of the Local Government Board dated 30th June 1898, assigning further powers to the Port Sanitary Authority of London Sanitary Inspectors (Change of Designation) Act, 1956 Public Health Officers Regulations, 1959 S.I. No. 962 AIRCRAFT Public Health (Aircraft) Regulations, 1952 and 1954. S.I. 1952, No. 1410; 1954, No. 674 ALIENS Aliens Order, 1953, S.I. No. 1671 Ministry of Health Instructions to Medical Inspectors, 1955 ANIMALS Export Cattle Protection Order, 1957, S.I. No. 170 Export Cattle Protection (Amendment) Order. 1957. S.I. No. 1254 CANAL BOATS Public Health Act, 1936 Public Health Act, 1961 CONSTITUTION OF THE AUTHORITY Public Health (London) Act, 1936 CREW ACCOMMODATION Public Health (London) Act, 1936 Merchant Shipping (Crew Accommodation) Regulations, 1953. S.I.No.1036; 1954S.I.No. 1660 DANGEROUS DRUGS Dangerous Drugs Regulations, 1953 FERTILISERS AND FEEDING STUFFS Fertilisers and Feeding Stuffs Act, 1926 Fertilisers and Feeding Stuffs Regulations, 1960. S.I. No. 1165 FOOD Public Health (Preservatives, etc. in Food) Regulations, 1925 to 1948. S.R. & 0. 1925, No. 775; 1926,1557; 1927, No. 577; 1940, No. 633 ; 1948, No. 1118 Public Health (Imported Milk) Regulations 1926. S.R. & 0. No. 820. Public Health (Imported Food) Regulations, 1937 and 1948. S.R. & 0. 1937, No. 329; S.I. 1948, No. 886. FOOD (continued) Food and Drugs (Whalemeat) Regulations, 1949 and 1950. S.I. 1949, No. 404; 1950, No. 189 Food and Drugs Act, 1955 Colouring Matter in Food Regulations, 1957. S.I. No. 1066 Antioxidant in Food Regulations, 1958. S.I. No. 1454. Fluorine in Food Regulations, 1959. S.I. No. 2106 Arsenic in Food Regulations, 1959. S.I. No. 831; 1960. S.I. No. 2261. Food Hygiene (Docks, Carriers, etc.) Regulations, 1960. S.I. No. 1602. Food Hygiene (General) Regulations, 1960. S.I. No. 1601. Meat (Staining and Sterilization) Regulations, 1960. S.I. No. 1268. FUMIGATIONS Hydrogen Cyanide (Fumigation of Ships) Regulations, 1951. S.I. No. 1760. Hydrogen Cyanide (Fumigation of Buildings) Regulations, 1951. S.I. No. 1759 HOUSEBOATS Public Health (London) Act, 1936 City of London (Various Powers) Act, 1933, Part III. Sections 6 and 7 INFECTIOUS DISEASE Public Health (London) Act, 1936 Public Health (Ships) Regulations, 1952 and 1954. S.I. 1952, No. 1411; S.I. 1954, No. 675 Public Health (Ships) (Amendment) Regulations, 1961; S.I. 1961, No. 13 Public Health (Infectious Disease) Regulations, 1953. S.I. No. 299 RATS AND MICE Public Health (Ships) Regulations, 1952 and 1954. S.I. 1952, No. 1411; S.I. 1954, No. 675 Prevention of Damage by Pests Act, 1949 Prevention of Damage by Pests (Application to Shipping) Order, 1951. S.I. No. 967 Prevention of Damage by Pests (Application to Shipping) (Amendment No. 2) Order, 1956 Poison Rules, 1958 SHELLFISH Public Health (Shellfish) Regulations, 1934, S.R. & 0, No. 1342. Order dated 23rd April 1936 made by the Port Health Authority under the Public Health (Shellfish) Regulations, 1934 in respect of a "prescribed area" in Essex Order dated 25th July 1957 made by the Port Health Authority under the Public Health (Shellfish) Regulations, 1934 in respect of a "prescribed area" in Kent Medway (Shellfish) Regulations, 1935, S.R. & 0. No. 1221 SMOKE ABATEMENT Public Health (London) Act, 1936 Clean Air Act, 1956 Dark Smoke (Permitted Perioda) Regulations, 1958. S.I. No. 498 Dark Smoke (Permitted Periods) (Vessels) Regulations, 1958, S.I. No. 878 bye-laws Bye-laws have been made by the Port Health Authority: 1. For preventing nuisances arising from barges or vessels carrying offensive cargoes. 2. For removing to hospital any person suffering from dangerous infectious diseases, and for the keeping therein of such persons as long as may be deemed necessary. 3. With respect to houseboats used for human habitation within the limits of the Port of London. publications of the port health authority Corporation of London as the Port Health Authority of the Port of London: A Summary of Powers and Duties. Clean Food Handling. Social Services: Information as to National and Voluntary Organisations ready to assist the seafarer and his family. appendix vi Imported Foods and the Nation: Some Recent Problems WHEN I was asked whether I would write this paper, I welcomed the suggestion as affording an opportunity of explaining some of the difficulties experienced in the Port of London from time to time, and their solution by the means that are available at the time. The action taken is often forced upon us by circumstances with results that may not always be understood by colleagues in districts remote from the urgency of port work. They may find, for instance, some tons of meat, Salmonella-contaminated, arriving in their districts for manufacturing use "at processing temperatures sufficient to destroy the contaminating bacteria and subject to such steps being taken as appeared necessary to prevent any risk of cross contamination within the plant." A medical officer probably would not know that perhaps 20 other medical officers were aski ng: why the port health authority were sending that meat into their district. The reason is that often there is little time for formal meetings or the delay of correspondence; decisions must frequently be made whilst the cargo is being actually discharged. In addition to the five large dock groups within the Port of London Health Authority's district, the riverside wharves in the City of London also come under my jurisdiction. Within the Port of London there are the riverside wharves lying within the areas of eight riparian authorities each of which operates as a port health authority in regard to imported food. Imported food falls to be examined in the docks unless it is discharged overside for H.M. Customs clearance and examination in the area of a riparian authority. Maintenance of close liaison is essential between these authorities to secure uniformity of action throughout the Port, and between ports, to secure the same uniformity throughout the country. The Port of London receives annually food imports of approximately 1,250,000 tons valued at about £700,000,000. Of this, meat accounts for 550,000 tons valued at about £190,000,000. Approximately 50 per cent of all food imports and 60 per cent of total meat imports pass through the port. To have written a paper under this heading even five, and certainly ten, years ago would have been a simple task compared with that of today, and it would be convenient to confine the contents to problems that have arisen during the last five years. Previously the sixth sense of the experienced food inspector told him what to look for and where to look for it, and with the help of the public analyst, and very occasionally the bacteriologist, one felt reasonably well satisfied that a job had been well done, and that little food not "wholesome for man's body and fit to be sold", as the Worshipful the Fishmongers' Company aptly puts it, passed through the ports for distribution throughout the country. Today the sixth sense is training itself to discern the types of food which are liable to harmful bacterial contamination, and the newly established sources of supply in which processing techniques and hygienic standards perhaps lack the benefit of experience in food preparation. It must be realized that there are limits to the number of staff available for food inspection and in the facilities of the laboratories, both analytical and bacteriological, to examine samples, and at times these limits are somewhat stretched. It would be physically impossible for the Port staff to examine in detail all imported food. The unit of inspection is, of course, the shipment, with sub units of trade or establishment marks, and the first problem is the storage, when necessary, of shipments detained for further and more extensive examination. The accommodation for cold storage within the docks, especially in the case of meat, is insufficient to allow the holding of many shipments pending reports upon bacteriological sampling, and it is by co-operation with fellow medical officers of health that the shipment goes forward under detention into their area for storage and whatever subsequent action may be appropriate. For example, it was not possible recently to undertake the necessary 100 per cent examination of accumulating shipments of diseased South American livers at the docks, and these were siphoned off into the cold stores within the City of London and Finsbury where facilities exist for the detailed examination required. 1. RECENT PROBLEMS The following gives a short account of some of the recent problems and the manner in which they were dealt with. (a) Egg Products The first introduction to large-scale bacteriological problems was the finding of salmonella organisms in Chinese egg albumen. Within a very short time sampling was being carried out at the rate of 5,000 per year, which disrupted not only the well-planned allocation of the food inspectors' time, but also the normal work of the Public Health Laboratories, resulting in reports being received up to four and five weeks after submission of samples, consequent delays in clearance of cargoes, and mounting shortage of available storage space. Frozen egg products from Commonwealth and other countries added to the pressure on the limited cold storage space. Sampling was carried out on a five per cent basis, any positive samples necessitating a further 10 per cent examination which, if yielding further positive reports, led to the condemnation of the entire shipment. Should no positive results be obtained from the 10 per cent sampling, the shipment was released with the exception of the case or cases giving positive results on the original five per cent examination. Experience showed that the distribution of salmonella was not uniform and that a positive result was quite likely upon a further sampling of a container yielding preliminary negative results and vice versa. In fact experiments were carried out by continuous sampling of a shipment yielding a low rate of positive samples until eventually a 100 per cent positive result was obtained from every container. All egg products were therefore regarded as suspect, irrespective of negative reports. Heat treatment was found to be the effective answer to the problem. Release was given subject to a process of heat treatment at an approved centre, for high temperature baking under supervision, or for industrial purposes not involving human consumption or necessitating a health hazard through cross contamination of other foodstuffs. Shipments of egg products are still detained pending receipt of bacteriological report and salmonella contamination is still present, the problem being accepted as inseparable from this article of food. (b) Tea With little advance warning, on 1 January 1959, the examination of imported tea ceased to be carried out by officers of H.M. Customs and Excise and devolved upon port health and local authorities. In London, sampling for analysis by H.M. Customs had been carried out at a rate of between 3,000 and 5,250 per annum yielding from 0-2 per cent to 2 per cent adverse reports. From samples of tea taken by the Port Health Authority under the Imported Food Regulations and in the City of London under the Food and Drugs Act it soon became evident that teas from certain countries, especially Formosa and Indonesia, contained lead and lead compounds much in excess of the limit of 10 p.p.m. recommended by the Food Standards Committee in 1954. Enquiries have elicited no definite information as to the source of this metallic contamination, but a suggestion has been made that it is not unconnected with the artificial colouring of the tea. The problem was fairly easy to solve, and blending with lead-free teas in such proportion that the resulting lead content was well within the recommended limit was permitted. A recent shipment of 17 tons of Formosa tea reported by the Public Analyst as containing 269 p.p.m. lead and lead compounds was considered unsuitable for blending and was surrendered for destruction. (c) Prawns In 1959 examination of samples of Japanese prawns showed the presence of coagulase-positive staphylococci of food poisoning types. No statutory bacteriological standard was available to aid assessment as to fitness. Surface plate counts as high as 75 million were reported, and of 110 samples, 16 exceeded 2,000,000 either with or without staphylococci of food poisoning types. A number of conferences were held at which my riparian colleagues and I discussed the position with bacteriologists of the Central Public Health Laboratory and medical officers of the Ministry of Health in an endeavour to formulate some standard which could reasonably be applied to prawns, and it was agreed that application of a fairly simple standard appeared to give a reasonable assessment of fitness. A two-day surface plate count at 37°C of 250,000 per gm. or less is perfectly satisfactory. Anything in excess of 2,000,000 is regarded as unfit, and within this range the presence of coagulasepositive staphylococci and B. coli are taken into account. In any case of doubt and in all cases when rejection is contemplated, further samples are taken, the examination results of which have always enabled an assessment to be made. Earlier shipments bore no labelling of any description, and it was considered that cautionary labelling should properly appear on the cartons of such items of food so readily susceptible to spoilage and possible proliferation of contaminating bacteria if improperly stored. The importers co-operated by requesting their shippers to label all packs: (i) Keep contents at "deep freeze" temperature until ready for use; (i) Allow to defreeze at normal temperature; (iii) Do not re-freeze. This has now been adopted generally by packers. To Japan have been added Brazil, Spain, China, Egypt and India and as each new importer enters the trade so one must be prepared for the teething troubles of high plate counts, presence of staphylococci and absence of cautionary labelling. Reviewing the results of sampling for 1960, an improvement is apparent. Of 115 samples only two had surface plate counts exceeding 2,000,000, the highest being 3,500,000 and faecal contamination was greatly reduced. The main problem was to evolve an agreed provisional standard against which bacteriological reports could be measured. In dealing with an article of food such as prawns, the medical officer of health is not entitled to take into consideration the potential danger of improper storage, or the danger that might arise in the smaller restaurant by keeping an opened carton for a considerable time, with consequent liability of bacterial multiplication to dangerous proportions. These shipments are of considerable value, but in no case has it been necessary formally to seize any shipment for a Justice's decision, the importer always having voluntarily surrendered the goods upon explanation of the reasons for rejection. (d) Livers A few years ago a significantly increasing volume of imported livers, mostly marked as intended for animal feeding purposes, drew attention to the fact that no means of control existed in regard to such meat, whatever may have been the suspicions that all was not in fact sold for consumption by animals. Shipments invariably passed through many hands before disposal, but a number of consignments were traced to the point of final disposal, some finding their way into chain retail butchers' shops. It must be remembered that port health authorities had powers only in respect of meat intended for sale for human consumption. Inspection had shown that a high percentage of the livers were affected with the Echinococcus cyst, a stage in the life cycle of the dog tape worm; the cause, in at least one recorded case, of a human death. If, as was suspected, some of this liver was being sold for human consumption, the medical officer of health surely had a moral duty if not a statutory one in his regard for the public health. This was the position then. In the course of perfectly legitimate trade these livers were imported for animal feeding, the importer probably being quite unaware of the condition of the meat. By the time it had been sold and resold the original intention may have become less binding, and as the affection was not readily apparent without incision, and once divorced from the sack and its marking all identity was lost, to all intents and purposes there was a perfectly good liver fit for human consumption. By this time, however, the shipment had passed out of the hands of the port health authority and no authority had any official interest in its whereabouts or disposal. At the worst it was sold for human consumption; at the best people were in effect feeding their dogs with embryo tapeworms. The problem of gaining effective control was engineered by the application of section 111 of the Food and Drugs Act, 1955, which allows the presumption that an article of food, stored in a place in which similar food intended for human consumption is usually stored, is intended for human consumption unless the contrary is proved. A consignment of affected livers was removed from the Port of London into a cold store in the City of London, in which fit livers for human consumption were stored. The consignment was promptly presumed to be intended for human consumption, inspected and found to be unfit, seized and taken before a Justice who condemned them as unfit for human consumption and ordered that disposal be made to the satisfaction of the medical officer of health. The medical officer of health agreed upon release for animal feeding purposes only if the eventual user gave a guarantee as to use, and upon receipt of this document final disposal was passed into the jurisdiction of the local medical officer of health for his control. Once some control over this meat was established a system of voluntary advance notification of shipments of meat not intended for human consumption was adopted. Notification included details of eventual user and address. This imposed no interfence with legitimate trade in this class of meat, and in fact facilitated rapid clearance in the docks. It is noticeable that no applications are received for disposal to retail butchers' shops. There is little doubt that this particular problem did much to bring into being the Meat (Staining and Sterilization) Regulations, I960, whereby all unfit imported and butcher's meat must be sterilized before sale. An incidental point arising from this is the insistence of many pet owners that raw meat only be fed to their pets, but this may not always be in their best interests. (e) Salmonella contamination of meat The incidence of salmonella contamination of boneless meat imports generally has led to routine check sampling of such shipments for bacteriological examination so that contaminated cargoes may be diverted into the canning factory or other manufacturing channels where the heat process involved would destroy the organisms. Early in 1960 a shipment of boneless meat from a country newly entering the meat trade was routine sampled. Of 10 samples taken five were reported as salmonella contaminated, in one of which heat-resistant Clostridium welchii type 10 was also found. There were no grounds, at the time of sampling, to justify detention of the shipment and by the time the bacteriological reports were received it had been distributed, but it was decided that future shipments would automatically be detained to await bacteriological reports. Shipment no. 2 of this meat was discharged at a wharf in the City of London. The shipment was placed under detention and removed to various cold stores in the City and in Finsbury. The report on 22 samples from this shipment showed no salmonella and the shipment was released accordingly. Shipment no. 3 was discharged and distributed into cold stores in the City of London, Bermondsey and Finsbury. Ten samples from the City Cold Stores were examined, no salmonella being found, but a report was received from another district that Salmonella typhimurium had been isolated from part of the shipment. Shipment no. 4 was reported salmonella free. Shipment no. 5 consisting of bone-in-beef hindquarters and boneless meat was detained. No positive reports were received on the bone-in-beef samples and this was accordingly released, but four of 17 samples of boneless meat were reported as "salmonella found" three of which were Salm. typhimurium. The boneless meat consisted of specified cuts, strip loins, hindquarters, flanks, topsides, rumps, silversides, crops, briskets, forequarter flanks, thick flanks, shins, fillets and full crops, and further sampling of each cut was carried out. Salmonella organisms were isolated from samples of silversides, shins, topsides, and forequarter flanks, and all but these cuts were released. Further sampling of the detained cuts resulted in the isolation of salmonella organisms in 10 of 66 samples of silversides, eight of which were Salm. typhimurium-, five of 57 samples of topsides, of which one contained Salm. typhimurium, with heat-resistant CI. welchii type 5 from two samples; and two of 27 samples of forequarter flanks, in one of which was Salm. typhimurium and heatresistant CI. welchii type 6. No further salmonellapositive reports were received on 10 samples of shins. It was decided that the particular cuts from which salmonella organisms of heat-resistant CI. welchii types 1-13 had been isolated would be released for manufacturing purposes only, provided the process involved heat treatment sufficient to destroy the organisms and on condition that the medical officer of health of the district in which the process would be carried out was satisfied that the danger of cross contamination was negligible and that he was prepared to undertake supervision of the handling and processing. Visits by veterinary officers of the Ministry of Agriculture, Fisheries and Food to the offending slaughterhouse and the adoption of recommendations made by them no doubt resulted in 192 samples of the first shipment thereafter giving completely negative results with absence of faecal contamination. This was achieved, it is understood, principally by the proper drainage of the slaughterhouse floor, the raising of carcase rails to avoid contact of the carcase with the floor and the use of a clean swab for each carcase instead of a periodical change of swab. Shipments are now arriving in satisfactory condition. (/) Horse/neat Reports were received that imported horsemeat was being displayed for sale as pet food in a number of fish shops. Samples showed salmonella contamination, and cross contamination was feared not only in the shop but at the home of the purchaser. Substantial shipments of horsemeat are regularly imported, principally from South American countries. Under the Imported Food Regulations horseflesh is not "meat"—horse is not included as an "animal" and the interpretation of meat is the flesh of an animal. Under the Regulations a certificate of the veterinary authority in the country of origin certifying that the animal from which the meat was derived had received ante and post mortem examination, and had been found fit for human consumption, must accompany all imported meat and meat products and is known as an Official Certificate. It follows that as horseflesh is not meat but "an article of food" no Official Certificate is necessary. Most shipments, however, are accompanied either by an Official Certificate or other veterinary certificate, some, in addition, being marked "for animal feeding" or "unfit for human consumption". Here then we would have a veterinary certificate certifying fitness for human consumption of horseflesh marked "unfit for human consumption" or "for animal feeding only". Only food intended for sale for human consumption can be inspected, but should the veterinary certificate or the legend on the bag be accepted? In the first place was it, in fact, fit for human consumption ? Sampling revealed heavy salmonella contamination, in some cases as high as 100 per cent of the samples taken. Now a further difficulty arises. "Horse" apparently is an animal for the purposes of the Meat Staining and Sterilization Regulations, and also under these regulations "meat" only excludes bones, blood, whalemeat or a whole dead animal so that horseflesh is at last "meat". The Regulations require all unfit imported meat to be sterilized before sale. Horseflesh marked "for animal feeding" or "unfit for human consumption" would not be sampled and detained under the Imported Food Regulations, but it could under the Staining and Sterilization Regulations in order to ascertain whether or not the meat is fit. Again this is a commodity that passes through a number of hands before disposal, the importer having little idea as to ultimate user or use. At a meeting with the principal importers it was agreed that shipments accompanied by either an Official Certificate or a veterinary certificate of fitness would be accepted for human consumption, and would be sampled but not detained. All other shipments would be regarded as unfit and subjected to sterilization. Information of shipments sampled is forwarded to the medical officer of health of the district of destination notifying him that the results of bacteriological examination would be forwarded to him when received. Should the meat be required for retail sale or for pet food in a retail food shop he can detain until the results of examination are received before deciding whether release for that purpose would be justified. If intended for manufacturing purposes he can safely allow it to go forward if he is satisfied as to the heat treatment involved and the absence of risk of cross contamination. It is understood that steps are being taken in the country of origin concerned to reduce contamination in those slaughterhouses having adverse reports, and bacteriological examination is being carried out at source by the veterinary department of the government concerned. This particular problem is still with us and it remains to be seen whether the steps taken are effective. (g) Desiccated Coconut It had become evident early in 1960 from the bacteriological reports on samples of desiccated coconut from Ceylon that extensive salmonella contamination was to be expected. All shipments were automatically detained initially for five per cent bacteriological examination, positive reports entailing a further 10 per cent examination. Positive reports upon the 10 per cent examination resulted in condemnation of the entire shipment. In the early part of the year there were approximately 75 mills in actual production of desiccated coconut in Ceylon, many of which were primitive in construction and operation and in which scant regard was paid to hygiene. With few exceptions the output of all mills was bulked and packed for export at Colombo. In the absence of any batch or mill identification marks, it was inevitable that condemnation involved the whole shipment, and from the experience gained in earlier dealings with importations of other items of food on a similar scale, it was considered that a proper system of marking should be instituted in Ceylon without delay so that condemnation could be confined to the output of particular mills or batches rather than shipments. The importers of this product themselves faced the threat to the trade by direct representations to the Ceylon authorities, and one well-known firm instituted a very useful on-the-spot survey of the conditions under which the mills were operating, contacting and urging action by government departments, addressing meetings of millers and disseminating advice on the reorganization of the industry on sound principles of hygiene. The urgency of the position was stressed by the Ministry of Health by representation to the Ceylon authorities. Experiments were carried out in this country in an endeavour to evolve a process of sterilization practical of application to bulk imports, or factory, processing techniques which would remove any possible hazard and in which the possibility of cross infection would be obviated. Short and long time heat treatment, ultra-supersonic vibration, irradiation with gamma rays, and steam were tried. Treatment with ethylene oxide was entirely successful experimentally but its use is prohibited by the Preservatives in Food Regulations. The heat treatment applied by many of the manufacturing processes in which desiccated coconut is normally used would appear to be sufficient for destruction of the contaminating organism, but there remains the risk of salmonella cross-contamination of the plant, equipment, and finished product. Bearing in mind the paucity of direct evidence incriminating coconut as a significant source of food poisoning during the many years it must have been imported in a contaminated condition, it seemed reasonable to offer release for manufacturing purposes only, provided the contaminating organisms were not Salm. paratyphi-B, Salm. thompson, or Salm. typhimurium. The medical officer of health of the area in which the factory was situate was also requested to satisfy himself that the danger of cross-contamination was negligible, that the heat treatment applied by the process was sufficient to effect sterilization, and that it would be used under his supervision. Only one firm accepted these conditions and, having done so, they carried out continuous sampling of the finished product. Not one salmonella-positive report has been received from this sampling procedure. Desiccated coconut contaminated with any of the three salmonella types mentioned was surrendered by the owners to form a stock of known contaminated material available for laboratory experimental purposes, or was destroyed. In Ceylon, certain mills were selected for modernization and operation under conditions designed to exclude as far as possible the risk of contamination arising within the mill itself during the various processes, the output being separately packed. Regulations designed to control the milling, transport, packing and export of desiccated coconut have been issued by the Ceylon Government. Provision is made for registration of mills conforming to the standard required, and for the registration of shippers who must agree to ship their coconut on an export licence obtained from the Ceylon Coconut Board, their supplies being derived only from registered mills. A laboratory is being set up to work in close association with the Medical Research Institute in Colombo for the examination of samples drawn from the mills, adverse reports upon which will render the miller liable to refusal of an export licence for a definite period. Although percentage sampling is not an ideal method of assessment, it is interesting to record that in two instances importers requested 100 per cent examination at their own expense with the following results: Five per cent and 10 per cent sampling of 380 bags comprising shipment "A'' gave a contamination rate of 8-8 per cent, and 100 per cent sampling of the shipment gave a rate of 8-9 per cent. Five per cent and 10 per cent sampling of 482 bags comprising shipment "B" gave a contamination rate of 8-3 per cent, and 100 per cent sampling of the shipment gave a rate of 12-2 per cent. It is understood that four or five mills have satisfied the requirements of the Ceylon Regulations. It has been repeatedly suggested that each mill should mark its output with an identifying mark to enable the source of contamination to be traced. At present a shipment usually bears a number of marks, some being the importers mark and some presumably the mill or exporters mark. There is no information as to the significance of these marks, and the whole shipment therefore is sampled and dealt with as a unit. It is hoped the marks used by the mills which have reached registration standard will be notified in due course. (h) Cheese In 1960 a survey of the bacteriological condition of imported cheese was undertaken. Many samples showed very high surface plate counts, and in a number of samples coagulase-positive staphylococci of a foodpoisoning type. Little or no information could be obtained from any source as to what would be an acceptable limit of bacterial contamination in cheese, but it was considered that such plate counts as 150 million, 40 million, 15 million with the presence of coagulase-positive staphylococci were excessive, and the attention of the authorities of the exporting country was drawn to the unsatisfactory results obtained. A serious view was taken of the position by the exporting country and government investigations were put in hand immediately. On the day Government officers of the exporting country called to explain what steps were being taken to eliminate contamination, reports of two food poisoning outbreaks were received in the Port Health office. Both were at hospitals, one involving 100 patients and the other 35 patients. Bacteriological investigation on the spot in both instances confirmed the cause as being cheese from the country whose representatives had been interviewed that day. Enquiries elicited the fact that cheese rejected for direct sale at time of manufacture and imported for processing in this country had been supplied in error to the hospitals for direct consumption. All stocks were immediately withdrawn from distribution, and the question as to whether the cheese was even suitable for processing was considered. The active growth of the staphylococcus is accompanied by the creation of enterotoxin, and although in processing the cheese the heat treatment involved would be sufficient to destroy the organism it would not destroy the enterotoxin. No technique is at present available for the determination of the presence of enterotoxins although it is understood one has been evolved and will be available in time, so that the problem was being approached somewhat theoretically and academically. It was further stated that the staphylococcus count was reduced with time, so that at moment of time "A" there could be an extremely high plate count with consequent rapid production of enterotoxin, but at moment of time "A" + "B" the plate count could be negligible but the toxin level still dangerously high without possibility of determination. Bacteriological sampling of cheese before export will be carried out in future by the exporting country, and only that reaching a certain standard will be allowed for export. All milk used for cheese manufacture will be pasteurized at 162°F for 15 seconds before use. Cheese similar to that which caused food poisoning at the hospitals was later consumed by a number of officers of the Ministry of Health with no untoward result. 2. CONCLUSIONS How far the United Kingdom falls short of being self-supporting in food production may be gauged by those who remember how the available food, and much of that imported, was rationed during time of war. Meat, butter, cheese, eggs, sugar, tea—practically every article of food constituting our basic meals was rationed in minute portions. The nation's food imports are dictated by a host of individual tastes which the world's exporters are continuously attempting to supply and appeal to, leading to imports of quick-frozen frogs' legs from Cochin, chicken and shark soup from China, egusi (crushed melon seed), yam flour, bitter leaves and gari from Africa. These foods were unheard of a few years ago, and when egusi and bitter leaves are found to contain salmonella organisms a further problem is added to the list, that of discovering what they are and what they are used for. The pattern of food examination is changing with the emphasis now on bacterial condition. It may fairly be asked that if foods such as cheese, coconut, prawns etc. have had no record as the causative agent in food poisoning for the many years they have been coming into the country, why create trouble by looking for bacterial contamination ? The cause of food poisoning is often never established, and it is felt that if the item of food is found to be potentially capable of causing poisoning it cannot be accepted as fit for human consumption. It may be apparent from the instances quoted in this paper that in some cases relatively simple action in the exporting country can rectify the position, in others at least the potential danger is recognized and a sterilizing heat treatment applied. I am not asking for all food to be sterile—far from it. But I do think there is a limit, which is not always welldefined, beyond which it is not safe to go. When assessing the fitness of food it should be borne in mind that what may be quite innocuous to the healthy adult may not be so to the child or the sick. APPENDIX VII From Where does Leaf Assimilate the Deadly Cumulative Poison of Lead? SOME apprehension seems to be felt about the new Lead in Food Regulations which come into force on April 16. Indeed, the Mail last week went so far as to say that by forbidding the use of tea containing more than 10 parts per million of lead, the Regulations would place an unfair imposition on the trade and be likely to result in imports of Formosa tea into the United Kingdom becoming negligible. But are not such comments more unfair than the Regulations, which only seek to protect the public from a particularly insidious and cumulative poison? They could be most damaging to the reputation of Formosa tea, most of which, to judge from hundreds of analyses, contains hardly any more lead than Indian, Ceylon or African tea. Some fine teas have come from Formosa in the past and there is no reason why they should not be equally welcome in the future. To bring into perspective the potential interference to the tea trade, the reports of the Port and City of London Health Authorities for 1960, the latest published, show that of the 3,191 samples of tea analysed only 20 or 0.6% were found to contain lead in excess of 10 parts per million. Since samples submitted for analysis have already been seeded to some extent by the Sampling Officers this percentage is biassed and the true proportion of the total tea imports containing excessive lead would probably be much lower. Furthermore, the samples reported against were not all Formosa but included teas from two other countries. Where there may be any reason to suspect that any kind of food might contravine the Food & Drugs Act or any Regulations made under it, two precautions can be taken by the importers: (1) to insist upon a protective clause in their contract providing for cancellation if the food is stopped by a Port Health Authority, and (2) to obtain a sample of each invoice and have it tested before confirming the order. To be on the safe side, any teas showing a lead content exceeding 6 parts per million should be avoided, or at best, accepted with reservations. To an outside observer it seems surprising that the recent consignments of Formosan tea, which entailed considerable losses to the importers concerned, were apparently accepted without such precautions, although it had been known for two years that high leads had been found in similar grades of tea. Lead Foil Abandoned But the most obvious step, when any undesirable substance is found in food, is surely to find out how it gets in. This is not the first time lead has been found in tea and the trade will recollect that high proportions were found some 25 years ago. The lead was then found to be due to abrasion of the lead liners of the chests. The use of lead foil was discontinued and the trouble ceased. A few more sporadic cases have since occurred, which it is understood were raced to the use of solder for repairing worn machinery and to the flaking of dilapidated lead paint in certain factories. Lead is of course not the only harmful impurity that can find its way into tea. Nor is tea the only food in which it has been found. Outbreaks of lead poisoning in this country have occurred from the consumption of cider and beer containing 1 to 2 parts per million of lead derived from lead arsenate spraying and from the use of lead piping, now believed to have been completely eliminated. In the peasant village of Sopic in Serbia an epidemic of severe nephritis with 37 deaths, has recently been traced to the use of flour containing 1 to 2 parts per million of lead, deriving from an old stone water mill, the pitted surfaces of which had been repaired with compounds of lead. In Rotherham in 1955 an outbreak occurred affecting 60 children, with 2 deaths, in some poorer class houses, which was traced to lead-containing dust from discarded battery casings which had been used as a cheap fuel. In certain parts of Queensland, where exposure to lead appears to be abnormal, poisoning has occurred and subsequent records of 165 children discharged from hospital as cured showed that 94 died of chronic nephritis 15 to 20 years later. In America, in particular, recent investigations have shown that serious and permanent mental retardation can result from lead encephalopathy in young children afflicted by the habit of chewing anything within reach, traces of lead being derived from the paint. Many other instances of lead poisoning have also been recorded and from the accumulated medical and analytical evidence it has been possible to deduce the maximum safe limits for various foods. Narrow Margin The real trouble with lead is that it is cumulative, and that there is such a small margin of safety between the average amount we ingest from food, drink and the atmosphere everyday and the amount which the body can eliminate. This margin, culled from 40 investigations, appears to be as little as half a milligram a day, or a hundredth of a grain; if we take more than that it becomes deposited in the bones and after a time a point is reached when the skeleton will absorb no more and, influenced by health, diet and other factors, discharges the surplus lead into the blood stream, where it is carried to susceptible organs causing the outward symptoms of lead poisoning. For this very reason a heavy dose of a lead compound, most of which might pass undissolved through the body, is less to be feared than minute but repeated doses which, added to other past and future doses, could produce a chronic toxicosis years later—usually too late for any connection to be established with the source or for any redress by the unfortunate consumer. The public have the right through their representatives to legislate to protect their health; and certainly no one in the tea trade would care to run the risk of tea being responsible for, or in any way associated with, the next outbreak of lead poisoning. By laying down definite limits for all foods the Regulations will ensure that the same standard is adopted all over the country and enable producers to know what is required. The lead limit for most foods has been fixed at 2 parts per million. For those kinds of food and drink which are consumed in large quantities it is lower, —0.2 to 1 part per million; for others, consumed in only small quantities, it varies from 5-20 parts per million. The design being to ensure that the probable intake from any particular food will not exceed \ milligram in one day. It is, of course, to be hoped that food producers will endeavour, as they have in the past, to exclude lead from their products entirely; indeed, if all the food we consumed contained the maximum amounts of lead to be permitted by the Regulations it can be calculated that an average intake would exceed 3 milligrams a day, and we should all be suffering from lead poisoning within a few months. The Regulations cannot, therefore, be regarded as unduly severe. In the case of tea, due allowance has been made for the small weight normally used per person and the assumption has also been made that probably only about one-third of the lead will pass into the liquor. In view of the evidence, obtained from thousands of analyses, that the normal lead content of tea is from 1 to 3 parts per million and that anything over 5 is very rare, the limit of 10 parts per million should not be difficult to comply with. By way of comparison the U.S.A. limit of 2.5 for lead in imported tea may be mentioned. The solution of the Formosa problem is, however, one that can only be cleared up by the producers themselves. No plants are known to. the writer that absorb lead compounds from the soil through their root system and translocate it to their leaves. It would, therefore, seem probable that the lead is adventitious; but whether it comes from dust from the soil settling on the leaf, from lead-containing insecticides, from lead in the machinery, from paint, from the workers or from any other souro is a question for investigation on the spot; and surely this would be worthwhile. The Sardine Problem Encouragement may perhaps be drawn from the analogous example of lead in sardines, which was solved in 1933. For some time excessive amounts of lead, up to 70 and even 150 parts per million, had been found in canned sardines imported from Portugal. Complaints to the producers had no effect, but since Portuguese sardines were preferred by many customers importers were reluctant to discontinue theii supplies. Eventually the directors of a large catering firm, one of the principal users of sardines, thought it worth while to send one of their number, who was also their Chief Chemist, out to Portugal to investigate the source of the lead. In quite a short time, Dr. L. H. Lampitt discovered that the tin-coated grills, on which the fish were steam cooked, were actually coated with a lead-tin solder instead of pure tin and that the solder was being attacked by the salted fish and lead absorbed. Once the cause was traced it was a simple matter to replace the offending grills by new ones tested and found free from lead. Since then the lead content of Portuguese sardines has given no further cause for anxiety and much credit is due to Messrs. J. Lyons & Co., Ltd., for conducting this investigation in the interests of public health and for publishing their findings. One Millionth of an Ounce A final point in connection with lead analyses arises from the comment that " different analysts using the official method often obtain varying results from samples drawn from the same chest." If the lead is in the form of separate particles varying results are unfortunately inevitable, for it is hardly likely that any two small portions weighed out for analysis would each contain a particle or particles of exactly the same weight. One has to bear in mind that the actual weight of lead to be determined by the analyst in the case of a tea containing 10 parts per million of lead is of the order of a millionth of an ounce. Apart from the particle variations, such determinations require considerable skill and experience. The best method is rather lengthy and, if results are found to vary the only course open to the Analyst, after checking the accuracy of the method, is to carry out several determinations and find the mean. In the case of the Formosa tea referred to, however, the lead does not appear to be present in the form of separate, detached particles, but to be intimately mixed with the tea, and duplicate analyses have in the writer's experience agreed quite closely. It was because of the possibility of variations in different parts of the same chest that the advice was given above to avoid as far as practicable any teas yielding lead figures over 6 parts per million. %